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Sleep Disordered Breathing in Four Resource-Limited Settings in Peru: Prevalence, Risk Factors, and Association with Chronic Diseases

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dc.contributor.author Schwartz, Noah G.
dc.contributor.author Rattner, Adi
dc.contributor.author Schwartz, Alan R.
dc.contributor.author Mokhlesi, Babak
dc.contributor.author Gilman, Robert Hugh
dc.contributor.author Bernabé Ortiz, Antonio
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Checkley, William
dc.contributor.author CRONICAS Cohort Study Group
dc.date.accessioned 2019-02-06T14:53:40Z
dc.date.available 2019-02-06T14:53:40Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5450
dc.description.abstract STUDY OBJECTIVES: Sleep disordered breathing (SDB) is a highly prevalent condition in high-income countries, with major consequences for cardiopulmonary health, public safety, healthcare utilization, and mortality. However, its prevalence and effect in low- and middle-income countries are less well known. We sought to determine the prevalence, risk factors, and comorbidities of SDB symptoms in four resource-limited settings. DESIGN: Cross-sectional analysis of the CRONICAS Cohort, a population-based age- and sex-stratified sample. SETTING: Four resource-limited settings in Peru varying in altitude, urbanization, and air pollution. PARTICIPANTS: There were 2,682 adults aged 35 to 92 y. MEASUREMENTS AND RESULTS: Self-reported SDB symptoms (habitual snoring, observed apneas, Epworth Sleepiness Scale), sociodemographics, medical history, anthropometrics, spirometry, blood biomarkers were reported. We found a high prevalence of habitual snoring (30.2%, 95% confidence interval [CI] 28.5-32.0%), observed apneas (20.9%, 95% CI 19.4-22.5%) and excessive daytime sleepiness (18.6%, 95% CI 17.1-20.1%). SDB symptoms varied across sites; prevalence and adjusted odds for habitual snoring were greatest at sea level, whereas those for observed apneas were greatest at high altitude. In multivariable analysis, habitual snoring was associated with older age, male sex, body mass index (BMI), and higher socioeconomic status; observed apneas were associated with BMI; and excessive daytime sleepiness was associated with older age, female sex, and medium socioeconomic status. Adjusted odds of cardiovascular disease, depression, and hypertension and total chronic disease burden increased progressively with the number of SDB symptoms. A threefold increase in the odds of having an additional chronic comorbid disease (adjusted odds ratio 3.57, 95% CI 2.18-5.84) was observed in those with all three versus no SDB symptoms. CONCLUSIONS: Sleep disordered breathing symptoms were highly prevalent, varied widely across four resource-limited settings in Peru, and exhibited strong independent associations with chronic diseases. en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartofseries Sleep
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Odds Ratio en_US
dc.subject Cohort Studies en_US
dc.subject Cross-Sectional Studies en_US
dc.subject Urbanization en_US
dc.subject Aged en_US
dc.subject Aged, 80 and over en_US
dc.subject Middle Aged en_US
dc.subject Peru/epidemiology en_US
dc.subject Altitude en_US
dc.subject Prevalence en_US
dc.subject Risk Factors en_US
dc.subject Comorbidity en_US
dc.subject Social Class en_US
dc.subject Body Mass Index en_US
dc.subject Hypertension/epidemiology en_US
dc.subject Cardiovascular Diseases/epidemiology en_US
dc.subject Chronic Disease/epidemiology en_US
dc.subject Health Resources en_US
dc.subject Air Pollution/statistics & numerical data en_US
dc.subject chronic diseases en_US
dc.subject Depression/epidemiology en_US
dc.subject population-based study en_US
dc.subject Sex Characteristics en_US
dc.subject Sleep Apnea Syndromes/epidemiology en_US
dc.subject sleep disordered breathing en_US
dc.subject Sleep Stages en_US
dc.subject Snoring/epidemiology en_US
dc.title Sleep Disordered Breathing in Four Resource-Limited Settings in Peru: Prevalence, Risk Factors, and Association with Chronic Diseases en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.5665/sleep.4988
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.25
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.07
dc.relation.issn 1550-9109


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