关键词: 睡眠呼吸暂停, 阻塞性, 患病率, 横断面研究, 社区筛查, 人体测量指标

Abstract: Objective To investigate the prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) among adults aged 40 to <60 years in Nanjing, to elucidate its associated risk factors, and to evaluate the diagnostic efficacy of neck circumference (NC), waist circumference (WC), and body mass index (BMI) for community-based screening. Methods A stratified, multi-stage, cluster randomized sampling design was employed to recruit 500 permanent residents aged 40 to <60 years in Nanjing from January to December 2025. Data acquisition involved standardized questionnaires, anthropometric examinations, and overnight polysomnography. Binary logistic regression analysis was utilized to identify independent factors associated with OSAHS. Receiver operating characteristic (ROC) curves were constructed to compare the screening efficacies of the respective anthropometric indices. Results Among the 500 participants, 90 were diagnosed with OSAHS, yielding an overall prevalence of 18.00% (95% CI: 14.88%-21.61%). The cohort comprised mild, moderate, and severe cases, accounting for 22.22%, 48.89%, and 28.89% of the diagnoses, respectively. The prevalence was significantly higher in males than in females (26.89% vs. 9.92%) and in the 50-<60 age demographic compared to the 40-<50 age cohort (23.27% vs. 12.94%). A spatial gradient was also observed, with prevalence progressively decreasing from the urban core (23.53%) to the inner suburbs (17.26%) and outer suburbs (12.66%) (all P<0.05). Multivariate logistic regression demonstrated that male sex (OR=1.983), age 50-<60 years (OR=2.926), prolonged sedentary behavior (≥8 h/day: OR=2.368), snoring (occasional: OR=1.994; frequent: OR=7.142), nocturnal awakening with choking or gasping (OR=3.743), central obesity (OR=3.365), and an NC>40 cm (OR=2.552) were independently associated with an increased risk of OSAHS (all P<0.05). The area under the curve (AUC) values for NC, WC, and BMI in screening for OSAHS were 0.772, 0.727, and 0.712, respectively. Conclusion The prevalence of OSAHS is notably high among the 40-<60 age demographic in Nanjing. Male sex, advanced age, prolonged sedentary behavior, snoring, nocturnal choking, central obesity, and increased neck circumference constitute independent risk factors. Notably, neck circumference exhibits superior screening efficacy, suggesting its utility as the primary anthropometric indicator for preliminary OSAHS screening in community settings.

Key words: Sleep apnea, Obstructive, Prevalence, Cross-sectional studies, Community screening, Anthropometric indicators