The health risks and benefits of cycling in urban environments compared with car use: health impact assessment study

Abstract

Introduction: Obesity is a major risk factor for developing sleep apnea syndrome. CPAP is its treatment. Moreover, the use of CPAP may decrease perioperative complications in patients who have to undergo bariatric surgery. - Objective: To study the prevalence of OSAS in morbidly obese subjects. - Methods: We studied all patients who were referred to our unit of sleep disorders with an obesity diagnosis, using the following inclusion criteria: BMI higher than 40, acceptance of polygraphy. All patients answered a clinical questionnaire in order to assess: symptoms of sleep apnea and cardiometabolic comorbidity. Additionally, they all went through a polygraphic or polysomnographic study. The diagnosis of OSA was established with the presence of an AHI higher than 5 and the severity rating was made according to the SEPAR criteria. - Results: In three years we have studied 292 subjects with the stablished criteria, 115 men, 176 women, average age 47.1 +/-14. Average BMI 46.7. SAHS diagnosis was established in 243 cases (83.5% prevalence) of which 54 (22.2%) had mild OSA, 62 (25.5%) moderate OSA, and 127 (52.2%) severe OSA. In patients with OSA, the Epworth test average result was 7.43 +/-4.5 and in terms of comorbidity, 106 patiens had hipertension, 43.6%, 89 had dyslipidemia (36.6%) and 60 had diabetes (24.6%), 11 had had ischemic events (4.7%) and 5 had cerebrovascular disease (2%). - Conclusions: Individuals with morbid obesity have a very high prevalence of OSA in the absence of significant hypersomnolence. The need to treat these patients makes us recommend the routinary performance of polygraphic studies, even in paucisymptomatic patients.