View Abstract

A3965 - Suspected Obstructive Sleep Apnea and Risk of Injuries Among Rural Dwellers
Author Block: J. A. Dosman1, C. P. Karunanayake1, W. Pickett2, D. C. Rennie3, J. Lawson4, M. E. Fenton4, F. Chung5, P. Pahwa6; 1Canadian Centre for Health and Saftey in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada, 2Department of Public Health Sciences, Queen's University, Kingston, ON, Canada, 3College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada, 4Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada, 5Department of Anesthesiology, University of Toronto, Toronto, ON, Canada, 6Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada.
Rationale: Based on our recently completed longitudinal Saskatchewan Rural Health Study (SRHS), we showed that the personal factors of excess body weight and loud snoring are associated with high rates of suspected moderate-to-severe and severe obstructive sleep apnea (OSA) as determined by the STOP-Bang algorithm with a two-step scoring strategy. We believe that a considerable proportion of OSA remains undiagnosed in these populations and may be an important risk factor for the observed high prevalence of injuries. Objective: To investigate the relationship between suspected OSA as determined by the STOP-Bang algorithm and risk of injury in rural populations of Saskatchewan. Methods: The Saskatchewan Rural Health Study was a prospective cohort study conducted in two phases; the 2010 baseline and a four-year follow-up in 2014. At baseline, 8261 participants, aged ≥18 years completed the mail-out survey. Information on STOP-Bang questionnaire items and injury was collected from 4867 rural dwellers. The STOP-Bang questionnaire was used in the SRHS follow-up survey as a means of identifying people with suspected low, moderate and high risk for OSA. The STOP-Bang questionnaire consists of eight dichotomous (Yes/No) items consisting of Snoring (S), Tiredness (T), Observed apnea (stopped breathing) (O), high blood pressure (P), BMI (B), age (a), neck circumference (n), and male gender (g). The total score ranges from 0 to 8. Those with a STOP-Bang score of ≥ 5 were considered high risk; those with a score of 3-4 were considered moderate risk; and those with score of 0-2 were considered low risk. Those with moderate risk were further classified into high risk category if one of the following conditions was met: STOP score ≥ 2 + male; STOP score ≥2 + BMI >35; or STOP score ≥ 2 + neck circumference >40cm. Outcome of interest was the injury occurrence (Yes/No) during the last 12 months. The association between OSA risk categories with outcome was assessed using logistic regression modeling techniques adjusting for potential confounding. Results: Thirty-nine percent had low risk, 33.7% moderate risk, and 27.4% high risk for suspected OSA based on STOP-Bang two step scoring strategy. Injury risk was associated with the STOP-Bang score [odds ratio (95% confidence interval)]: high risk of suspected OSA [1.59 (1.27, 1.99)] and moderate risk of suspected OSA [1.30 (1.04, 1.61)]: both compared to low risk of suspected OSA. Conclusions: A STOP-Bang score of 3 or higher is associated with increased risk of injury in these rural populations.