Prevalence of Obstructive Sleep Apnea Among Lebanese Patients With Chronic Kidney Disease: Its Repercussion on Disease Trajectory and Its Effect on Patients' Quality of Life.

Abstract

Background and Objectives: Chronic kidney disease (CKD) remains a public health threat and a major cause of morbidity and mortality worldwide. A bidirectional relationship is found between sleep disorders and CKD worldwide. However, to our knowledge, this study is the first to assess the prevalence of obstructive sleep apnea (OSA) and to evaluate its impact on the progression of other comorbidities among Lebanese patients with CKD. Materials and Methods: The study is an observational cross-sectional study, carried out between September and November 2021. Lebanese patients with any stage of CKD were included. Patients' characteristics were collected via electronic health record and baseline questionnaires. We screened for obstructive sleep apnea using the STOP-Bang questionnaire. Results: We included 168 patients. The prevalence of OSA among our patients was 47.6%. The prevalence of OSA is higher in males compared with females (81.2% vs. 18.8%, p=0.002). Obesity was more prevalent in patients with OSA compared with patients without OSA (42.5% vs. 19.3%, p=0.002). Among the 168 patients, 69.6% had hypertension, with a significantly higher prevalence among those with OSA compared with those without OSA (81.2% vs. 59.1%, p=0.003). Patients with OSA reported significantly lower scores compared with those without OSA in several domains of physical and emotional health, including physical functioning (54.06 vs. 66.88, p=0.002), role limitations due to physical health (42.19 vs. 63.07, p=0.001), role limitations due to emotional problems (49.17 vs. 69.32, p=0.004), pain (61.31 vs. 70.45, p=0.019), and physical component score (52.53 vs. 69.53, p=0.002). All the abovementioned parameters were also examined in two subpopulations: patients with CKD and ESRD. Similarly, some comorbidities and a lower physical QOL score were observed more in patients with OSA in these two subpopulations. Conclusion: Patients with OSA in our study have higher probability of being male, obese, and hypertensive as well as poorer QOL compared with their counterparts without OSA. Implementing more effective screening and treatment of OSA in CKD patients is necessary.