The Epidemiology of Adult Obstructive Sleep Apnea

Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21224, USA.
Proceedings of the American Thoracic Society 03/2008; 5(2):136-43. DOI: 10.1513/pats.200709-155MG
Source: PubMed


Obstructive sleep apnea is a chronic condition characterized by frequent episodes of upper airway collapse during sleep. Its effect on nocturnal sleep quality and ensuing daytime fatigue and sleepiness are widely acknowledged. Increasingly, obstructive sleep apnea is also being recognized as an independent risk factor for several clinical consequences, including systemic hypertension, cardiovascular disease, stroke, and abnormal glucose metabolism. Estimates of disease prevalence are in the range of 3% to 7%, with certain subgroups of the population bearing higher risk. Factors that increase vulnerability for the disorder include age, male sex, obesity, family history, menopause, craniofacial abnormalities, and certain health behaviors such as cigarette smoking and alcohol use. Despite the numerous advancements in our understanding of the pathogenesis and clinical consequences of the disorder, a majority of those affected remain undiagnosed. Simple queries of the patient or bed-partner for the symptoms and signs of the disorder, namely, loud snoring, observed apneas, and daytime sleepiness, would help identify those in need of further diagnostic evaluation. The primary objective of this article is to review some of the epidemiologic aspects of obstructive sleep apnea in adults.

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    • "Obstructive sleep apnea (OSA) is characterized by repeated episodes of complete obstruction of the upper airway, resulting in oxygen desaturation and arousal from sleep. The prevalence of OSA is 2e5% in adult women and 3e7% in adult men [1]. The symptoms that these patients may experience are sleepiness, morning headaches , tiredness and fatigue, reduced vigilance and executive function, memory impairment, depression and impotence. "
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    ABSTRACT: This systematic review summarizes the evidence regarding the quality of patient-reported outcome measures (PROMs) validated in patients with obstructive sleep apnea (OSA). We performed a systematic literature search of all PROMs validated in patients with OSA, and found 22 measures meeting our inclusion criteria. The quality of the studies was assessed using the consensus-based standards for the selection of health status measurement instruments (COSMIN) checklist. The results showed that most of the measurement properties of the PROMs were not, or not adequately, assessed. For many identified PROMs there was no involvement of patients with OSA during their development or before the PROM was tested in patients with OSA. Positive exceptions and the best current candidates for assessing health status in patients with OSA are the sleep apnea quality of life index (SAQLI), Maugeri obstructive sleep apnea syndrome (MOSAS) questionnaire, Quebec sleep questionnaire (QSQ) and the obstructive sleep apnea patient-oriented severity index (OSAPOSI). Even though there is not enough evidence to fully judge the quality of these PROMs as outcome measure, when interpreted with caution, they have the potential to add value to clinical research and clinical practice in evaluating aspects of health status that are important to patients.
    Sleep Medicine Reviews 10/2015; 28:14-27. DOI:10.1016/j.smrv.2015.07.006 · 8.51 Impact Factor
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    • "Sleep Apnea-Hypopnea Syndrome (SAHS) is one of the most common disorders affecting sleep, characterized by the repeated occurrence of involuntary episodes of total or partial reduction in patient's respiration during the night [1]. Several studies have been carried around the world during the last years, which estimate that the prevalence of SAHS is between the 3% and the 7% of the adult population [2] [3]. Patients suffering from SAHS present involuntary respiratory pauses that repeats throughout the night. "
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    ABSTRACT: Automatic diagnosis of the Sleep Apnea-Hypopnea Syndrome (SAHS) has become an important area of research due to the growing interest in the field of sleep medicine and the costs associated with its manual diagnosis. The increment and heterogeneity of the different techniques, however, make it somewhat difficult to adequately follow the recent developments. A literature review within the area of computer-assisted diagnosis of SAHS has been performed comprising the last 15 years of research in the field. Screening approaches, methods for the detection and classification of respiratory events, comprehensive diagnostic systems, and an outline of current commercial approaches are reviewed. An overview of the different methods is presented together with validation analysis and critical discussion of the current state of the art.
    08/2015; 2015(8). DOI:10.1155/2015/237878
    • "Sleep-disordered breathing (SDB) is an important public health problem. Population prevalence estimates range between 5% and 20% [1] [2], depending on the population studied and the definition used. Many individuals with this disorder remain undiagnosed in the general population [3]. "
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    ABSTRACT: Objective/background: Via this systematic review and meta-analysis, we assessed the association between sleep disordered breathing (SDB)/obstructive sleep apnea (OSA) and cancer incidence. Methods: Medline, Embase, Cochrane central, and electronic databases were searched for relevant studies in any language. Studies were included if they: 1) studied patients with SDB/OSA, 2) reported cancer incidence rates specific to patients with SDB/OSA and 3) SDB/OSA was defined using sleep study based objective measures. Quality of included studies was assessed using Newcastle-Ottawa Quality Assessment Scale (NOQA). Results: Of the 8766 retrieved citations, 5 studies that defined SDB/OSA using apnea-hypopnea index (AHI) or respiratory disturbance index (RDI) totaling 34,848 patients with SDB and 77380 patients without SDB were pooled into a meta-analysis. All 5 studies were of good quality (NOQA ≥ 6). Five hundred seventy four (1.6%) and 290 (0.37%) incident cancers were reported in patients with and without SDB, respectively. In the unadjusted analysis, patients with SDB/OSA were at increased risk for incident cancer (RR: 1.53, 95% CI: 1.31 – 1.79, P < 0.001, I2: 0, 5 included studies). When adjusted for traditional cancer risk factors, the association between SDB/OSA and cancer incidence, though it attenuates (RR: 1.40, 95% CI: 1.01 – 1.95, P = 0.04, I2: 60%, 5 included studies), remains significant. Conclusions: SDB/OSA may increase risk of incident cancer. Inferring an independent association is not possible from our analysis considering the retrospective cohort design of the included studies and high inter-study heterogeneity. An individual patient data meta-analysis would help to validate our findings.
    Sleep Medicine 05/2015; 16(10). DOI:10.1016/j.sleep.2015.04.014 · 3.15 Impact Factor
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