A multicenter retrospective study of patients with obstructive sleep apnea in two hospitals in Tibet plateau and Beijing plain

Abstract

Abstract To study Tibetan and Han adult male patients with Obstructive Sleep Apnea Syndrome (OSAS) in two hospitals in Tibet Plateau and Beijing Plain, and to explore the clinical characteristics of adult male OSAS patients in Tibet Plateau. 100 and 86 adult male OSAS patients diagnosed by Polysomnography (PSG) in Tibet Autonomous Region People’s Hospital and Peking University Third Hospital from April 2017 to October 2021 were retrospectively analyzed, and the following data were collected: Age, neck circumference, Body Mass Index (BMI), blood pressure, Apnea Hypopnea Index (AHI), proportion of N2 stage and REM stage, lowest oxygen saturation at night (LSpO2), etc. The differences between the two groups were analyzed. There were no statistical differences in age distribution (non-obese patients, BMI < 28 kg/m2), BMI, blood pressure, AHI, N2 stage, and AHI of mild and moderate OSAS patients between the two places. The age of obese patients (BMI ≥ 28 kg/m2) in plateau area (47 ± 12.7, n = 54) was higher than that in plain area (40.6 ± 8.2, n = 42, P < 0.05). The neck circumference (39.6 ± 4.4, n = 100) of patients from Tibet Plateau was significantly lower than that of patients from Beijing area (42 ± 2.7, n = 86, P < 0.05), the proportion of patients with history of hypertension (52.5%) was significantly higher than that of patients from Beijing area (37.2%), and the REM period (18.1 ± 7.3, n = 100) was significantly higher than that in patients treated in Beijing area (11.7 ± 6.2, n = 86, P < 0.05), and LSpO2 at night [66% (50-72%)] was significantly lower than that in patients treated in Beijing area [79% (65-85%), P < 0.05]. Among patients with severe OSAS in two places, the disease severity of patients in Tibet Plateau area [AHI = 62 (45.5–90.3)] was significantly higher than that in Beijing plain area [AHI = 53.8 (38.4–67), P < 0.05]. 96% of patients treated in the Tibetan plateau had LSpO2 below 80%, while 51% of patients treated in the Beijing Plain had LSpO2 below 80%. In plateau patients, BMI (OR = 1.242, 95% CI1.051-1.468) was an independent risk factor for AHI ≥ 15 times/h. There are differences in many clinical features between male Tibetan OSAS patients in Tibetan plateau hospitals and male Han OSAS patients in Beijing Plain hospitals. Compared with plain patients, plateau patients had smaller neck circumference, lower LaSO2, higher REM period and higher history of hypertension. Overall, the severity of the disease was higher in plateau patients than in plain patients. For Tibetan plateau men, BMI and neck circumference were independent risk factors for moderate to severe OSAS and could be used as predictors of OSAS severity.

Keywords

• Obstructive sleep apnea syndrome
• A high plateau
• The plain
• Male