Obstructive sleep apnea and hypopnea syndrome in patients admitted in a tertiary hospital in Cameroon: Prevalence and associated factors

Autoři: Virginie Poka-Mayap aff001;  Dodo Balkissou Adamou aff002;  Massongo Massongo aff001;  Steve Voufouo Sonwa aff003;  Jacqueline Alime aff003;  Ben Patrick Michel Moutlen aff003;  Alfred Kongnyu Njamnshi aff004;  Andre Noseda aff007;  Eric Walter Pefura-Yone aff001
Působiště autorů: Pulmonology Department, Yaounde Jamot Hospital, Yaounde, Cameroon aff001;  Faculty of Medicine of Garoua, The University of Ngaoundere, Garoua, Cameroon aff002;  Faculty of Medicine and Biomedical Sciences, The University of Yaounde I, Yaounde, Cameroon aff003;  Department of Internal Medicine and Subspecialties, Faculty of Medicine and Biomedical Sciences, The University of Yaounde I, Yaounde, Cameroon aff004;  Department of Neurology, Yaounde Central Hospital, Yaounde, Cameroon aff005;  Brain Research Africa Initiative (BRAIN), Yaounde, Cameroon aff006;  Pulmonology Department, Brugmann University Hospital U.L.B., Brussels, Belgium aff007
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0227778



Obstructive sleep apnea and hypopnea syndrome (OSAHS) is poorly documented in Sub-Saharan Africa, especially in the hospital setting. The aim of this study was to determine its prevalence and to investigate the associated factors in patients admitted in a tertiary referral hospital in Cameroon.


In this cross-sectional study conducted in the Cardiology, Endocrinology and Neurology departments of the Yaounde Central Hospital; all patients aged 21 and older were included consecutively. A sample of randomly selected patients was recorded using a portable sleep monitoring device (PMD). OSAHS was defined as apnea-hypopnea index (AHI) ≥ 5/hour (with > 50% of events being obstructive) and moderate to severe OSAHS as an AHI > 15/hour. Logistic regression was used to identify factors associated to OSAHS.


Of the 359 patients included, 202 (56.3%) patients were women. The mean age (standard deviation) was 58 (16) years. The prevalence of OSAHS assessed by PMD (95% CI) was 57.7% (48.5–66.9%), 53.8% in men and 62.7% in women (p = 0.44). The median (25th-75th percentiles) AHI, body mass index and Epworth Sleepiness Scale score of OSAHS patients were 17 (10.6–26.9)/hour, 27.4 (24.7–31.6) kg/m2 and 7 (5–9) respectively. The only factor associated to moderate to severe OSAHS was hypertension [odds ratio (95% CI)]: 3.24 (1.08–9.72), p = 0.036.


OSAHS is a common condition in patients in this health care centre of Cameroon. In the hospital setting, screening for OSAHS in patients with hypertension is recommended.

Klíčová slova:

Alcohol consumption – Body Mass Index – diabetes mellitus – Hypertension – Measurement equipment – Sleep – Sleep apnea – Sleep disorders


1. Schipper MH, Jellema K, Thomassen BJW, Alvarez-Estevez D, Verbraecken J, Rijsman RM. Stroke and other cardiovascular events in patients with obstructive sleep apnea and the effect of continuous positive airway pressure. J Neurol. 2017;264(6):1247–53. doi: 10.1007/s00415-017-8522-z 28550476

2. Xu S, Wan Y, Xu M, Ming J, Xing Y, An F, et al. The association between obstructive sleep apnea and metabolic syndrome: a systematic review and meta-analysis. BMC Pulm Med. 2015;15(1):105.

3. Engel S, Karoff M, Raschke F, Fischer J. Prevalence of sleep apnea syndrome with primary arterial hypertension in a cardiologic rehabilitation clinic. Pneumologie. 1995 Mar;49 Suppl 1:145–7.

4. Marin JM, Carrizo SJ, Vicente E, Agusti AGN. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet (London, England). 2005 Mar;365(9464):1046–53.

5. Peppard PE, Hagen EW. The Last 25 Years of Obstructive Sleep Apnea Epidemiology-and the Next 25? Am J Respir Crit Care Med. 2018 Feb 1;197(3):310–2. doi: 10.1164/rccm.201708-1614PP 29035088

6. Franklin KA, Lindberg E. Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J Thorac Dis. 2015 Aug;7(8):1311–22. doi: 10.3978/j.issn.2072-1439.2015.06.11 26380759

7. Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med. 2015 Apr;3(4):310–8. doi: 10.1016/S2213-2600(15)00043-0 25682233

8. Fietze I, Laharnar N, Obst A, Ewert R, Felix SB, Garcia C, et al. Prevalence and association analysis of obstructive sleep apnea with gender and age differences—Results of SHIP-Trend. J Sleep Res. 2018 Oct 1;e12770. doi: 10.1111/jsr.12770 30272383

9. Ozoh OB, Okubadejo NU, Akinkugbe AO, Ojo OO, Asoegwu CN, Amadi C, et al. Prospective assessment of the risk of obstructive sleep apnea in patients attending a tertiary health facility in Sub-Saharan Africa. Pan Afr Med J. 2014 Jan;17:302. doi: 10.11604/pamj.2014.17.302.2898 25328598

10. Balkissou A, Pefura-Yone E, Kenyo-Kenne C, Massongo M, Afane-Ze E. Prevalence and Determinants of Obstructive Sleep Apnea in Semi-urban and Rural Area of Cameroon. In: ATS conference. 2017.

11. Obaseki DO, Kolawole BA, Gomerep SS, Obaseki JE, Abidoye IA, Ikem RT, et al. Prevalence and predictors of obstructive sleep apnea syndrome in a sample of patients with type 2 Diabetes Mellitus in Nigeria. Niger Med J. 2014 Jan;55(1):24–8. doi: 10.4103/0300-1652.128154 24970965

12. Shaheen HA, Abd El-Kader AA, El Gohary AM, El-Fayoumy NM, Afifi LM. Obstructive sleep apnea in epilepsy: a preliminary Egyptian study. Sleep Breath. 2012 Sep;16(3):765–71. doi: 10.1007/s11325-011-0573-2 21904805

13. Jniene A, el Ftouh M, Fihry MT el F. Sleep apnea syndrome: experience of the pulmonology department in Ibn Sina Hospital, Rabat, Morocco. Pan Afr Med J. 2012 Jan;13:28. 23308333

14. Sharma S, Mather PJ, Efird JT, Kahn D, Shiue KY, Cheema M, et al. Obstructive Sleep Apnea in Obese Hospitalized Patients: A Single Center Experience. J Clin Sleep Med. 2015 Jul;11(7):717–23. doi: 10.5664/jcsm.4842 25766715

15. Shear TC, Balachandran JS, Mokhlesi B, Spampinato LM, Knutson KL, Meltzer DO, et al. Risk of sleep apnea in hospitalized older patients. J Clin Sleep Med. 2014 Oct 15;10(10):1061–6. doi: 10.5664/jcsm.4098 25317085

16. Zhang R, Guo X, Guo L, Lu J, Zhou X, Ji L. Prevalence and associated factors of obstructive sleep apnea in hospitalized patients with type 2 diabetes in Beijing, China 2. J Diabetes. 2015 Jan;7(1):16–23. doi: 10.1111/1753-0407.12180 24910109

17. Hansel B, Dourmap C, Giral P, Girerd EBX. Prévalence et déterminants du syndrome d ‘ apnée du sommeil chez des hommes ayant un syndrome métabolique et une hypertension artérielle contrôlée. Arch des Mal du coeur Vaiss. 2007;100(8):637–41.

18. Ben Ahmed H, Boussaid H, Hamdi I, Boujnah MR. Prevalence and predictors of obstructive sleep apnea in patients admitted for acute myocardial infarction. Ann Cardiol d’angéiologie. 2014 Apr;63(2):65–70.

19. Diaz K, Faverio P, Hospenthal A, Restrepo M, Amuan M, Pugh MJ, et al. Obstructive sleep apnea is associated with higher healthcare utilization in elderly patients. Ann Thorac Med. 2014 Apr;9(2):92. doi: 10.4103/1817-1737.128854 24791172

20. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991 Dec;14(6):540–5. doi: 10.1093/sleep/14.6.540 1798888

21. Nagappa M, Liao P, Wong J, Auckley D, Ramachandran SK, Memtsoudis S, et al. Validation of the STOP-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea among Different Populations: A Systematic Review and Meta-Analysis. PLoS One. 2015 Jan;10(12):e0143697. doi: 10.1371/journal.pone.0143697 26658438

22. Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, Islam S, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008 May;108(5):812–21. doi: 10.1097/ALN.0b013e31816d83e4 18431116

23. Berry R, Brooks R, Gamaldo C, Harding S, Llyod R, Marcus C, et al. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical specifications, Version 2.1. Darien, Illinois: American Academy of Sleep Medicine; 2014.

24. Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest. 2014 Nov;146(5):1387–94. doi: 10.1378/chest.14-0970 25367475

25. Njamnshi AK, Mengnjo MK, Mbong EN, Kingue S, Fonsah JY, Njoh AA, et al. Hypertension in Cameroon associated with high likelihood of obstructive sleep apnea: a pilot study. BMC Cardiovasc Disord. 2017;17(1):112. doi: 10.1186/s12872-017-0542-1 28482815

26. Epstein LJ, Kristo D, Strollo P, Friedman N, Malhotra A, Patil S, et al. Clinical Guideline for the Evaluation, Management and Long-term Care of Obstructive Sleep Apnea in Adults. J Clin Sleep Med. 2009;5(3):263–76. 19960649

27. Van den Broecke S, Jobard O, Montalescot G, Bruyneel M, Ninane V, Arnulf I, et al. Very early screening for sleep-disordered breathing in acute coronary syndrome in patients without acute heart failure. Sleep Med. 2014 Dec;15(12):1539–46. doi: 10.1016/j.sleep.2014.06.017 25308397

28. Martínez-García MA, Galiano-Blancart R, Soler-Cataluña J-J, Cabero-Salt L, Román-Sánchez P. Improvement in Nocturnal Disordered Breathing After First-Ever Ischemic Stroke. Chest. 2006 Feb;129(2):238–45. doi: 10.1378/chest.129.2.238 16478837

29. Correia LCL, Souza AC, Garcia G, Sabino M, Brito M, Maraux M, et al. Obstructive sleep apnea affects hospital outcomes of patients with non-ST-elevation acute coronary syndromes. Sleep. 2012;35(9):1241–5A. doi: 10.5665/sleep.2078 22942502

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