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Published ahead of print on November 6, 2003, doi:10.1164/rccm.200302-265OC

Am. J. Respir. Crit. Care Med., Volume 169, Number 2, January 2004, 168-173

A more recent version of this article appeared on January 15, 2004
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Submitted on February 24, 2003
Accepted on October 31, 2003

Prevalence of Sleep Disordered Breathing and Sleep Apnea in middle-aged Urban Indian Men

Zarir F Udwadia1*, Amita V Doshi1, Sharmila G Lonkar1, and Chandrajeet I Singh1

1 Chest Medicine, P. D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India

* To whom correspondence should be addressed. E-mail: zfu{at}vsnl.com.

No data is available on the prevalence of sleep disordered breathing (SDB) and obstructive sleep apnea-hypopnea syndrome (OSAHS) in Indians. We conducted a two-phase cross-sectional prevalence study for the same in healthy urban Indian males (35 to 65 years) coming to our hospital in Bombay for a routine health check. We also investigated its risk factors and evaluated the significance of the most commonly asked questions that best correlated with presence of OSAHS. In the first phase, 658 subjects (94%), returned completed questionnaires regarding their sleep habits and associated medical conditions. In the second phase, 250 of these underwent an overnight home sleep study. The estimated prevalence of SDB (apnea-hypopnea index >= 5) was 19.5% and that of OSAHS, (SDB with daytime hypersomnolence) was 7.5%. Multiple stepwise logistic regression determined body mass index, neck girth and history of diabetes mellitus as the principal covariates of SDB. Presence of snoring, nocturnal choking, unrefreshing sleep, recurrent awakening from sleep, daytime hypersomnolence and daytime fatigue was each statistically significant for identifying patients with OSAHS. The higher prevalence of OSAHS in urban Indian men is striking and may have major public health implications in a developing country.
Key words: Epidemiology, sleep study, India




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