Screening of Obstructive Sleep Apnea among Bangladeshi Adults in the US: Is it the Tip of the Iceberg? : Screening of Obstructive Sleep Apnea among Bangladeshi Adults in the USA

Obstructive sleep apnea (OSA) is a common, chronic, sleep-related breathing disorder characterized by repetitive episodes of partial and complete airway obstructions during sleep with repetitive apneas and hypopneas as a result. Common symptoms of OSA include snoring, nocturnal choking or gasping, excessive daytime sleepiness, nonrefreshing sleep, fatigue, nocturia, morning headache, and cognitive impairment. Snoring has the most sensitivity(82.6%) while nocturnal choking or gasping is the most specific (84%) Undiagnosed and untreated OSA attributed to hypertension (30%-70% of OSA patients), heart failure (140% rise in risk), CAD (30% rise in the risk of blockage), and stroke (60% rise in risk). Other long-term health consequences include diabetes, memory loss (including Alzheimer’s), depression, and other psychiatric conditions. Depending on the broad or stringent definition of OSA based on the apnea-hypopnea index (AHI), the prevalence of the condition in North America can range from 20-30% or 15% in males, and 10-15% or 5% in females. Asians and Indians have been found to have similar OSA severity, despite lower rates of obesity. However, research conducted among South Asians in the UK shows a higher prevalence of OSA than white Europeans. Limited research is done on OSA among South Asians in the US, particularly in the Bangladeshi community. The proportion of the population showing a high risk for the disease noticeably increases from 46 years onward. Male gender was found to be the major risk factor determining whether the subjects are at high, intermediate, or low risk. This conforms with other studies done previously. Although the study shows 30% of the population posing an increased risk for OSA, the outcome may be the same, lower, or higher after polysomnography. The author recommends a broader study with a follow-up of the intermediate and high-risk groups with an appropriate sleep study. Based on the preliminary findings, questions regarding OSA should be incorporated into routine health evaluations. Suspicion of OSA should trigger a comprehensive sleep evaluation. Steps should be taken to increase awareness at the community level to improve compliance with annual physicals and reduce risk behaviors.