The prevalence of syndrome Z (the interaction of obstructive sleep apnoea with the metabolic syndrome) in a teaching hospital in Singapore

Abstract

Background: Syndrome Z describes the interaction of obstructive sleep apnoea (OSA) with the metabolic syndrome. Purpose of study: A pilot study to determine the prevalence of syndrome Z in a teaching hospital in Singapore. Methods: Patients (age >18 years) recruited for this prospective study had to satisfy three of the following five inclusion criteria: fasting glucose .6.1 mmol/l, blood pressure >130/85 mm Hg, HDL cholesterol ,1.04 mmol/l in men and ,1.2 mmol/l in women, triglycerides >1.7 mmol/l, and a waist circumference .102 cm in men and .88 cm in women. All subjects underwent standard overnight polysomnography. Overnight fasting glucose and lipid levels were measured and baseline anthropometric data recorded. All sleep studies were scored and reported by a sleep physician. OSA was deemed to be present if the respiratory disturbance index (RDI) was >5, with mild, moderate and severe categories classified according to the Chicago criteria. Results: There were 24 patients (19 males and five females) of whom 10 were Chinese, eight Malay and five of Indian origin, with one other. Mean age was 48¡13.5 years, mean body mass index was 34.9¡6.1 kg/ m 2 and mean waist circumference was 111.3¡15.7 cm. 23 (95.8%) of the patients had OSA with a mean RDI of 39.6¡22.4 events/h with 15 patients (62.5%) in the severe category. The five patients who fulfilled all five criteria for diagnosis of the metabolic syndrome had severe OSA. Conclusion: The prevalence of OSA in our studied population exhibiting the metabolic syndrome is very high. Therefore, a polysomnogram should always be considered for this subset of patients.

The Impact of Obstructive Sleep Apnea on Metabolic and Inflammatory Markers in Consecutive Patients with Metabolic Syndrome

“…We found a 60.5% prevalence of OSA in MetS, even using conservative diagnostic OSA criteria (AHI ≥15 events per hour of sleep). The prevalence of OSA observed in this study is in line with two previous reports from different groups (ranging from 68 to 87.5%) that evaluated patients with MetS [17], [18]. Consistently with our data, a recent report found a high prevalence of OSA (∼86%) in obese patients with type 2 diabetes [31].…”

Obstructive Sleep Apnea Is Highly Prevalent and Correlates With Impaired Glycemic Control in Consecutive Patients With the Metabolic Syndrome

“…A high prevalence of MS among male patients with diagnosed OSA referred to sleep laboratories has been reported 12,13 . A recent pilot study 22 found a prevalence of 96% of OSA in 24 patients with MS when adopting a cutoff of ≥5 events/h. However, it was not clear whether the patients were recruited in a consecutive manner.…”

Hipertensión arterial y síndrome de apneas-hipoapneas del sueño en atención primaria

“…Los pacientes con SAHS presentan una gran prevalencia de síndrome metabólico 21---23 , así como los pacientes con SAHS e hipertensión arterial 16,24 , únicamente un pequeño porcentaje de casos de pacientes con SAHS deben su etiología a anomalías de tipo anató-mico cráneo-facial. A su vez se ha publicado que hasta un 95% de pacientes con síndrome metabólico pueden presentan SAHS 25 . Por lo tanto, dado que es un síndrome de fácil diagnóstico a partir de las exploraciones complementarias básicas en Atención Primaria, debería ser obligatorio el cribado de SAHS a todo paciente hipertenso que además cumpliera criterios de síndrome metabólico 11 .…”