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Prevalence and Risk Factors for OSA among Urban and Rural Subjects in Bengaluru District, South India: Across-sectional Study

Groups and Associations Uma Devaraj, Uma Maheswari K, Sujana Balla3, Ashna M Pinto, Kavitha Venkatnarayan , Priya Ramachandran , Chitra Veluthat, George D Souza
Indian Journal of Sleep Medicine 2021

Abstract

 Introduction: Prevalence rates of obstructive sleep apnea (OSA) in India vary widely due to diverse study settings. Besides, the literature comparing the prevalence of OSA between urban and rural settings is sparse. 

Aims and objectives: To determine prevalence and risk factors for OSA among urban and rural South Indian subjects. 

Materials and methods: This prospective study was carried out in seven census blocks in Bengaluru and seven villages in Anekal taluk. Clinical data were collected; Epworth sleepiness scale and Berlin questionnaire were used to screen for sleepiness and OSA, respectively. Subjects deemed high risk for OSA during screening underwent level III sleep study. Results: A total of 709 subjects (388 urban and 321 rural) were included. The mean age was 35.5 ± 10.6 years (urban subjects) and 39.4 ± 15.6 years (rural subjects). Those at risk of OSA after screening were 36 (6.7%) and 28 (8.7%) among urban and rural participants, respectively. The prevalence of OSA was 18 (4.6%) in urban and 12 (3.7%) in rural subjects. 

Discussion: The urban OSA group had significantly higher body mass index (27.6 vs 24.2 kg/m2 ; p = 0.05) and neck circumference (38.9 vs 34.4 cm; p = 0.0001). Although the overall prevalence of OSA was similar in both groups, urban subjects had a significantly higher prevalence of severe OSA (44 vs 8.4%). 

Conclusion: Prevalence of OSA was similar in urban and rural subjects but risk factors and OSA severity showed variation between the two groups, with urban subjects having unfavorable anthropometry and a higher proportion of severe OSA.