Rastreamento para síndrome da apneia obstrutiva do sono e fatores associados em população com hipertensão arterial sistêmica na Atenção Primária em Saúde

Abstract

Obstructive Sleep Apnea and Hypopnea Syndrome (OSAHS) is characterized by recurrent episodes of partial obstruction (hypopnea) or total (apnea) of the upper airway during sleep and reduction or interruption of airflow through the larynx, even with intensification of respiratory effort. OSAHS is neglected, prevalent in 30 to 56% in the hypertensive population, it is responsible for 80% of resistant hypertension (RH), causes daytime sleepiness, hyper-utilization of health services, reduced capacity to work, depressive symptoms, traffic accidents and is a risk factor for cardiovascular diseases (CVD). The present study aimed to determine the prevalence of positive screening for OSAHS and to identify associated factors in a hypertensive population in a Primary Health Care (PHC) service. A cross-sectional study was conducted with 326 hypertensive individuals enrolled in a medium-sized PHC unit in the Eastern Region of the state of Minas Gerais. The participants were interviewed between March and December 2018. Anthropometric, clinical and sociodemographic variables were obtained by an instrument constructed by the authors. The Short Assessment of Health Literacy for Portuguese-Speaking Adults (SAHLPA-18) questionnaires were used to identify literacy in health; the Morisky Medication Adherence Scale (MMAS-8), for medication adherence and Snoring, Tiredness, Observed Apnea, High Blood Pressure, Bodymass index, Age, Neck Circumference, and Gender - STOP-Bang, for the screening of OSAHS. The majority of the participants were female (66.3%), the mean age was 61.22 ± 10.32 years and the mean treatment time for high blood pressure (HBP) was 12.51 ± 9.83 years. The majority of people were classified with low literacy in health (69.0%) and 67.5% of the participants demonstrated medium and high medication compliance. The study identified 86.5% of positive screening for OSAHS and male and obesity as factors associated with this condition (p <0.001). The results shows that the screening of OSAHS should be done in hypertensive individuals, in PHC services, as it the screening is done for other chronic non-communicable diseases.