A patient had recurrent acute nocturnal pulmonary oedema following an anterior myocardial infarction despite a normal maximal stress electrocardiogram. He had a history of chronic heavy snoring and other symptoms to suggest a diagnosis of obstructive sleep apnoea (OSA) which was supported by an overnight sleep study. The recurrent acute pulmonary oedema was most likely due to a combination of poor left ventricular function and obstructive sleep apnoea.
OBJECTIVE: The aim of this study was to determine the prevalence of snoring and breathing pauses during sleep, and to assess associated factors, including morbidity and the impact on daytime functioning, in an adult Malaysian population.
METHODS: A cross-sectional survey of community-dwelling adults aged 30-70 years was conducted. Daytime sleepiness was assessed using the Epworth Sleepiness Scale. Physical examinations were limited to measurements of body habitus and blood pressure.
RESULTS: The sample consisted of 1611 adults (52.9% male). The prevalence of habitual snoring, breathing pauses and excessive daytime sleepiness were 47.3%, 15.2% and 14.8%, respectively. Seven per cent of respondents (8.8% male, 5.1% female) were clinically suspected to have obstructive sleep apnoea syndrome (OSAS). The independent predictors of habitual snoring were older age, Chinese or Indian ethnicity (compared with Malays), smoking, obesity and use of sedatives. Clinically suspected OSAS and habitual snoring were significantly associated with difficulty in getting up in the morning, morning headache, driving and workplace accidents, hypertension, and ischaemic heart disease.
CONCLUSIONS: The prevalence of habitual snoring is high in the Malaysian population. Sleep-related breathing disorders in Malaysian adults are associated with significant morbidity.