Obesity hypoventilation syndrome in obstructive sleep apnea patients in the United Arab Emirates: a retrospective cross-sectional study

JRSM Short Rep. 2013 Nov 21;4(12):2042533313510156. doi: 10.1177/2042533313510156. eCollection 2013 Dec.

Abstract

Objectives: To estimate the frequency of symptoms of obesity hypoventilation syndrome (OHS) in patients with obstructive sleep apnoea (OSA) and to evaluate comorbidities associated with OHS.

Design: Retrospective study based on patients' medical records and on further sleep tests performed in the study centre during the inclusion visit.

Setting: Respiratory Care Unit and Sleep Disorder Centre of the Zayed Military Hospital United Arab Emirates.

Participants: All patients referred to the study centre for a suspicion of sleep-disordered breathing.

Main outcome measures: Prevalence of OSA and OSA + OHS and comorbidities in patients with OSA and OHS.

Results: A total of 212 adult patients participated in the study. Of these, 107 patients (50.5% [43.8-57.1% CI 95%]) fulfilled diagnostic criteria for OSA, and the majority were men (79.4%). Among patients with OSA, 18 patients (16.8% [10.8-25.1% CI 95%]) fulfilled diagnostic criteria for OHS. In this group, women were more frequently affected than men (31.8% [7/22] vs. 12.9% [11/85], respectively; p = 0.03) and tended to be older than affected men, with a mean age of 55 ± 10.6 years versus 46 ± 13 for men. After adjustment for gender, OHS was significantly associated with hypertension (OR = 3.5; p = 0.03), diabetes mellitus (OR = 4.6; p = 0.02), ischaemic heart disease (OR = 5.1; p = 0.04) and pulmonary hypertension (OR = 16.1; p = 0.001).

Conclusion: OHS is a common condition in obese patients in the UAE and is associated with an increased risk of cardiovascular comorbidities and diabetes.

Keywords: Pickwickian syndrome; hyperpnoea syndrome; obesity; obstructive lung disease; obstructive sleep apnoea; pulmonary hypertension; restrictive lung disease.