What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Type 2 diabetes (n=306). Intervention: Waist circumference ≥100 cm vs. Waist circumference <100 cm. Primary outcome: High risk of obstructive sleep apnoea (STOP-BANG score ≥ 3) (OR 3.09, 95% CI 1.8-5.07, p=<0.001).

January 21, 2022Open Access

Assessment of the risk of obstructive sleep apnoea among patients with type 2 diabetes and its associated factors using the STOP-BANG questionnaire: A cross-sectional study

Q: What are the key findings of this study?

Among patients with type 2 diabetes, a waist circumference of 100 cm or greater was significantly associated with a higher risk of obstructive sleep apnoea (OR 3.09).

Key Result

Among patients with type 2 diabetes, a waist circumference of 100 cm or greater was significantly associated with a higher risk of obstructive sleep apnoea (OR 3.09).

Study Design

Type

Cross-Sectional (n=306)

Multicenter

Structured PICO

What is the risk of obstructive sleep apnoea and its associated factors among patients with type 2 diabetes?

Population

306 adults over age 18 with type 2 diabetes, assessed for obstructive sleep apnoea risk and associated clinical factors.

Exposure

STOP-BANG screening questionnaire

Outcome

Risk of obstructive sleep apnoea (OSA) and associated risk factorspatient reported

A high proportion (63.1%) of patients with type 2 diabetes in this Saudi cohort are at high risk for obstructive sleep apnoea, which correlates with obesity, hypertension, and diabetes duration.

Main Result

Odds Ratio: 3.09 (95% CI 1.8–5.07)

Absolute Event Rate: 74.8% vs 49.7%

p-value: p=<0.001

Limitations

Lack of polysomnography, which is the gold standard confirmatory test for OSA diagnosis.
Cross-sectional design cannot assess the impact of OSA risk on diabetes control and outcomes.
Hypothyroidism, which is a secondary cause of OSA, was not assessed in the recruited sample.

Abstract

To assess the risk of obstructive sleep apnoea (OSA) and its associated risk factors among patients with type 2 diabetes in southern KSA. This was a cross-sectional study conducted at the Armed Forces Hospital in Jazan. The prevalence of OSA was assessed using a validated Arabic translation of the STOP-BANG screening questionnaire. The odds of a higher OSA risk were calculated via regression analysis, according to the measured clinical and demographic variables. The total number of participants was 306, of which 213 (69.6%) were over the age of 50, 247 (80.7%) were married, and 161 (52.6%) were female. The overall median score of the OSA risk level assessed by the STOP-BANG items was three on a scale of 0–8, of which 193 (63.1%) of the participants in the sample were classified as being at high risk of developing OSA. Several statistically significant associations were identified, where odds ratios (ORs) with a higher OSA risk level were detected according to age, sex, marital status, waist and neck circumference, haemoglobin A1c (HbA1c) and body mass index levels, duration of diabetes, and comorbidity with hypertension (p < 0.05). The higher risk of OSA identified in our sample of diabetic patients can be related to a high prevalence of obesity, larger neck circumferences, hypertension, and other factors linked to the duration and treatment of diabetes. Additionally, the association between waist circumference, HbA1c, and duration since the diagnosis of diabetes suggests an interaction effect that requires further investigation.

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