title: Risk of obstructive sleep apnea among Saudis with chronic renal failure on hemodialysis.
abstract: OBJECTIVE
  The prevalence of obstructive sleep apnea (OSA) in end-stage renal disease (ESRD) patients was reported to be 10-fold that in the general population. OSA can worsen the clinical symptoms and cardiovascular complications of ESRD. We aimed to investigate the prevalence of symptoms and risk of OSA among Saudi patients with ESRD.
  
  
  METHODS
  This multi-center, cross-sectional study was conducted in Jeddah, Saudi Arabia, between June 2012 and September 2013.
  
  
  METHODS
  The prevalence of OSA was assessed using the Berlin questionnaire. The presence of daytime sleepiness was evaluated using the Epworth sleepiness scale. Data were also collected on the medical history, clinical, and laboratory findings of participants.
  
  
  RESULTS
  In all, 355 patients (61% male) were enrolled (mean age: 45.5 ± 15.4 years). The overall prevalence of high-risk of OSA was 44.2% (males, 47.3%; females, 44.8%; P = 0.65). The prevalence of excessive daytime sleepiness (EDS) was 74%. Controlling for age, gender and body mass index, multivariate analysis revealed that hypertension and hepatitis C infection were the only comorbidities significantly associated with OSA (odds ratio [OR]: 3.827 and 0.559; confidence interval [CI]: 2.120-6.906 and 0.324-0.964; P < 0.0001 and 0.036, respectively). OSA was also strongly associated with EDS (OR: 3.054; CI: 1.676-5.565; P < 0.0001).
  
  
  CONCLUSIONS
  In Saudi Arabia, the risk of OSA is more common in ESRD patients than in the general population. OSA is strongly associated with EDS. Interestingly, a significant negative correlation between OSA and hepatitis C infection was noted, which warrants further investigation.
authors.affiliation: Sleep Medicine and Research Center, Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
authors.forename: Siraj Omar
authors.initials: SO
authors.lastname: Wali
authors.affiliation: Department of Statistics, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Abeer
authors.initials: A
authors.lastname: Alkhouli
authors.affiliation: Sleep Medicine and Research Center, Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
authors.forename: Mohannad
authors.initials: M
authors.lastname: Howladar
authors.affiliation: Sleep Medicine and Research Center, Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ahmad
authors.affiliation: Renal Unit, Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
authors.forename: Saad
authors.initials: S
authors.lastname: Alshohaib
authors.affiliation: Renal Unit, Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
authors.forename: Saeed
authors.initials: S
authors.lastname: Al-Ghamdi
authors.affiliation: Sleep Disorders Center, Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
authors.forename: Ayman
authors.initials: A
authors.lastname: Krayem
keywords: Chronic renal failure; excessive daytime sleepiness; prevalence; risk of obstructive sleep apnea