Prevalence of Obstructive Sleep Apnea Using Home Sleep Test in Taiwan During the Coronavirus Disease Pandemic

Abstract

Background

Obstructive sleep apnea syndrome (OSAS) is a common disorder associated with serious sequelae. The current gold standard diagnostic method, polysomnography, is costly and time consuming and requires patients to stay overnight at a facility.

Aim

This study aimed to reveal the prevalence of OSAS in general adult population using a home sleep test (HST) during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

This prospective cohort study was conducted by the Department of Otolaryngology, Taipei City Hospital, Taipei, Taiwan, between January 2020 and December 2021. A total of 1372 patients aged 30–70 years completed an HST using a Type 3 portable sleep monitor (PM). The apnea-hypopnea index (AHI) was analyzed to assess the association of OSAS with age, body mass index (BMI), sex, Epworth Sleepiness Scale (ESS) and the Sleep Apnea Risk Assessment questionnaire (STOP-Bang questionnaire) rating.

Results

The mean age of the patients (782 men, 57%; 590 women, 43%) was 49.24 ± 11.04 years. OSAS was detected in 954 (69.5%) patients with 399 (29.1%) mild OSAS; 246 (17.9%) moderate OSAS; and 309 (22.5%) severe OSAS. Among these, the prevalence of moderate-to-severe OSAS was 143 (10.4%) in women and 412 (30.0%) in men. The mean age was the highest (51.29 ± 11.29) in the mild OSAS group and lowest (47.08 ± 10.87) in the healthy group. OSAS severity was greater with increasing BMI, 23.39 ± 3.44 in the healthy group and 29.29 ± 5.01 in the severe OSAS group. A positive correlation was also noted between the ESS/STOP-Bang questionnaire rating and OSAS severity.

Conclusion

The prevalence of OSAS in Taiwan was 69.5% in our study. It showed strong evidence that OSAS has important public health consequences and PMs are simple, fast, feasible, and cost-effective tools for OSAS screening in the home environment, especially during the COVID-19 pandemic.

Keywords:

• COVID-19
• obstructive sleep apnea
• portable sleep monitor
• home sleep test
• apnea-hypopnea index

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

This study complies with the Declaration of Helsinki.

Ethics Approval

All patients consented to study participation by signing written informed consent forms before enrolment. This study was approved by the Institutional Review Board of Taipei City Hospital, Taipei, Taiwan (TCHIRB-10908003-E). The Type 3 PM (ApneaLink Air) did not pose any hazard to the patients.

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

Consent to Publish

Patients signed written informed consent regarding publishing their data.

Acknowledgments

Acknowledgments to the Taipei City Health Bureau for their support.

Disclosure

The authors declare that they have no conflict of interest.

Additional information

Funding

Funding was provided by Taipei City Health Bureau, Taipei, Taiwan.