title: Uncovering the sleep disorders among young doctors.
abstract: OBJECTIVE
  Sleepiness and tiredness are common complaints among young doctors. Sleep deprivation is believed to be the main culprit. However, we believe that there may be other sleep disorders which may contribute to these symptoms such as occult obstructive sleep apnea (OSA).
  
  
  METHODS
  A prospective cross-sectional study was performed among young doctors less than 40 years old, working at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, and Hospital Kuala Lumpur, Kuala Lumpur, Malaysia, using questionnaires and home sleep apnea testing (Apnealink™Plus). The primary objective of this study was to evaluate the prevalence of OSA (apnea-hypopnea index (AHI) ≥5). The secondary objectives were to evaluate the prevalence of obstructive sleep apnea syndrome (OSAS) defined by AHI ≥5 + excessive daytime sleepiness (EDS), sleep deprivation (the difference of weekend (non-workdays) and weekday (workdays) wake-up time of at least 2 h), EDS (Epworth Sleepiness Scale score ≥10), tiredness, and perception of inadequate sleep as well as to identify their predictors.
  
  
  RESULTS
  Total of 52 subjects completed the study. Mean age and mean body mass index (BMI) were 31.3 ± 4 and 23.3 ± 3.6, respectively. The prevalence of OSA and OSAS were 40.4 and 5.8 %, respectively. One third of OSA subjects were at least moderate OSA. Prevalence of sleep deprivation, EDS, tiredness, and perception of inadequate sleep were 44.2, 15.4, 65.4, and 61.5 %, respectively. History of snoring, being male, and perception of inadequate sleep were significant predictors for OSA with the odds ratio of 34.5 (p = 0.016, 95 % CI = 1.92-619.15), 18.8 (p = 0.001, 95 % CI = 3.10-113.41), and 7.4 (p = 0.037, 95 % CI = 1.13-48.30), respectively. Only observed apnea was a significant predictor for OSAS with odds ratio of 30.7 (p = 0.012, 95 % CI = 2.12-442.6). Number of naps per week was a significant predictor for EDS with the odds ratio of 1.78 (p = 0.007, 95 % CI = 1.17-2.71). OSA and total number of call days per month were significant predictors for tiredness with the odds ratio of 4.8 (p = 0.036, 95 % CI = 1.11-20.72) and 1.3 (p = 0.050, 95 % CI = 1.0004-1.61), respectively. OSA was the only significant predictor for perception of inadequate sleep with the odd ratios of 4.5 (p = 0.022, 95 % CI = 1.24-16.59).
  
  
  CONCLUSIONS
  Our results demonstrated relatively high prevalence of OSA and OSAS among young doctors. Snoring, being male, and perception of inadequate sleep were significant predictors for OSA. Observed apnea was a significant predictor for OSAS. OSA was a significant predictor for tiredness and perception of inadequate sleep.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.|Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.|Institute of Respiratory Medicine, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.|Oriental Melaka Straits Medical Center, Pusat Perubatan Klebang, 75200, Melaka, Malaysia.
authors.forename: Rashidah
authors.initials: R
authors.lastname: Yasin
authors.affiliation: Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.|Section for Mathematics, Faculty of Science and Technology, Rajamangala University of Technology Suvarnabhumi, Phranakhon Si Ayutthaya, Thailand.|Rajamangala University of Technology Suvarnabhumi, 60 Moo 3 Asian Highway, Phranakhon Si Ayutthaya, 13000, Thailand.
authors.forename: Dittapol
authors.initials: D
authors.lastname: Muntham
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. narichac@hotmail.com.|Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. narichac@hotmail.com.|King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Bangkok, Pathumwan, 10330, Thailand. narichac@hotmail.com.
authors.forename: Naricha
authors.identifier: http://orcid.org/0000-0002-0945-3757
authors.initials: N
authors.lastname: Chirakalwasan
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008296:Malaysia; D008297:Male; D009784:Occupational Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D010820:Physicians / Q000706:statistics & numerical data; D017286:Polysomnography; D011446:Prospective Studies; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D012892:Sleep Deprivation / Q000175:diagnosis / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013785:Thailand
keywords: Excessive daytime sleepiness; Obstructive sleep apnea; Obstructive sleep apnea syndrome; Sleep disorder