Abstract

BackgroundObstructive sleep apnea (OSA) is a known risk factor for cardiovascular disease. This study aimed to describe the prevalence of OSA in the multi-ethnic population in Mauritius and its association to ischemic ECG abnormalities.

MethodA population-based health surveywithin the Mauritius NCD study was performed in 2009, in 5,952 individuals aged 19-78 years, who had complete data on anthropometry, blood pressure, glucose tolerance test andhealth questionnaire data. OSA was evaluated by the Berlin questionnaire and the cohort was divided into snorers and non-snorers. A 12-lead ECG was registered in individualsaged 35-75 years (n=4452, 48.0% snorers, 52.0% non-snorers). Ischemic ECG changes (I-ECG) were categorised according to the Whitehall criteria.

ResultsOf the participants 44.2% were snorers (n=2633), 40.5% had hypertension and 26.9% were obese. 54.3% of snorers and 7.8% of non-snorers had a high risk for OSA (OSA-high) (p<0.001). Prevalence of diabetes among snorers with OSA-high was 36.6% vs 20.6% in OSA-low (p<0.001) Same pattern seen in non-snorers. There was no ethnic difference in OSA risk.

Individuals with OSA-high had a higher prevalence of I-ECG compared with OSA-low, both among snorers (26.6% vs 18.3%, p<0.001) and non-snorers (29.5% vs 20.8%, p=0.002). In a multivariate regression adjusting for age, sex, ethnicity, history of CVD and known CVD risk factors, OSA was associated with I-ECG among snorers (OR 1.27, 95%CI 1.02-1.59), whereas no association was found between OSA and I-ECG in non-snorers.

Conclusion In this population-based sample, snoring individuals had a higher prevalence of high OSA risk compared with non-snorers. A high OSA-risk was associated with ischemic ECG changes among snorers.