Prevalence of obstructive sleep apnea in Asian adults: a systematic review of the literature

BMC Pulmonary Medicine

Erkin M Mirrakhimov¹  Talant Sooronbaev¹  Aibek E Mirrakhimov¹ 

[1] National Centre of Cardiology and Internal Medicine named after М. Mirrakhimov, T.Moldo Street 3, Bishkek, 720040, Kyrgyzstan

关键词: Systematic review;    Asia;    Prevalence;    Epidemiology;    Obstructive sleep apnea syndrome;    Obstructive sleep apnea;   

Others  :  1131290
DOI  :  10.1186/1471-2466-13-10

 received in 2012-06-11, accepted in 2013-02-21,  发布年份 2013

【 摘 要 】

Background

Obstructive sleep apnea (OSA) is a common disease, affecting approximately 2% of women and 4% of men residing in Western communities. No systematically reviewed data are available about the prevalence of this disease in Asia, the most heavily populated continent.

Methods

PubMed/Medline, Scopus and Google Scholar were searched for articles published from 1993 to May 2012 that reported the prevalence of OSA diagnosed via sleep monitoring and the prevalence of patients at risk for OSA as assessed by symptomatology and/or sleep questionnaires. We have also searched abstract database of major pulmonary and sleep scientific societies for relevant abstracts presented from 2010 to 2012. The following inclusion criteria were used: articles published in English, age ≥ 18 years, ≥ 100 participants in studies using sleep monitoring for the diagnosis of OSA, ≥ 300 participants in studies using questionnaires to detect patients at high risk for OSA. Exclusion criteria: duplicate publications, studies reporting the prevalence of central sleep apnea only, hospital based studies as well as studies assessing OSA prevalence among patients with resistant arterial hypertension, chronic kidney disease, heart failure and in patients with concomitant neurological disease.

Results

Twenty four articles were found to meet the inclusion criteria, covering 47,957 subjects (26,042 men and 21,915 women) and four relevant abstracts were noted. OSA prevalence ranged from 3.7% to 97.3%. Male gender, older age, a higher BMI and waist to hip ratio, greater neck circumference, arterial hypertension, smoking, snoring and daytime sleepiness were associated with OSA. Sample size, difference between the populations studied and the fact that some works included patients with a high pre-test probability of OSA explain the difference in prevalence rates.

Conclusion

This systematic review highlights the lack of data regarding the prevalence of OSA in Asians. Only a few studies provide an approximate estimate of the OSA burden in some Asian communities.

【 授权许可】

   
2013 Mirrakhimov et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The report of an American Academy of Sleep Medicine Task force Sleep 1999, 22:667-689.
• [2]Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP: Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 1999, 131:485-491.
• [3]Johns MW: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991, 14:540-545.
• [4]Eastwood PR, Malhotra A, Palmer LJ, Kezirian EJ, Horner RL, Ip MS, Thurnheer R, Antic NA, Hillman DR: Obstructive Sleep Apnoea: From pathogenesis to treatment: Current controversies and future directions. Respirology 2010, 15:587-595.
• [5]Moher D, Liberati A, Tetzlaff J, Altman DG: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009, 6(7):e1000097.
• [6]Dudenbostel T, Calhoun DA: Resistant hypertension, obstructive sleep apnoea and aldosterone. J Hum Hypertens 2012, 26:281-287.
• [7]Kasai T, Bradley TD: Obstructive sleep apnea and heart failure: pathophysiologic and therapeutic implications. J Am Coll Cardiol 2011, 57:119-127.
• [8]Mirrakhimov AE: Obstructive sleep apnea and kidney disease: is there any direct link?. 2011. [Sleep Breath] [Epub ahead of print]. PMID: 22170216
• [9]Centre for Reviews and Dissemination. Systematic reviews: CRD’s guidance for undertaking reviews in health care: Centre for Reviews and Dissemination, University of York. 2008. http://www.york.ac.uk/inst/crd/pdf/Systematic_Reviews.pdf webcite
• [10]Ozdemir L, Akkurt I, Sümer H, Cetinkaya S, Gönlügür U, Ozşahin SL, Nur N, Doğan O: The prevalence of sleep related disorders in Sivas. Turkey. Tuberk Toraks 2005, 53:20-27.
• [11]Kart L, Dutkun Y, Altın R, Ornek T, Kıran S: Prevalence of major obstructive sleep apnea syndrome symptoms in coal miners and healthy adults. Tuberk Toraks 2010, 58:261-267.
• [12]Liu SA, Liu CY: Prevalence of snoring in Taichung area: an epidemiological study. J Chin Med Assoc 2004, 67:32-36.
• [13]Chuang LP, Hsu SC, Lin SW, Ko WS, Chen NH, Tsai YH: Prevalence of snoring and witnessed apnea in Taiwanese adults. Chang Gung Med J 2008, 31:175-181.
• [14]Amra B, Farajzadegan Z, Golshan M, Fietze I, Penzel T: Prevalence of sleep apnea-related symptoms in a Persian population. Sleep Breath 2011, 15:425-429.
• [15]Khazaie H, Najafi F, Rezaie L, Tahmasian M, Sepehry AA, Herth FJ: Prevalence of symptoms and risk of obstructive sleep apnea syndrome in the general population. Arch Iran Med 2011, 14:335-338.
• [16]Nagayoshi M, Yamagishi K, Tanigawa T, Sakurai S, Kitamura A, Kiyama M, Imano H, Ohira T, Sato S, Sankai T, Iso H: Risk factors for snoring among Japanese men and women: a community-based cross-sectional study. Sleep Breath 2011, 15:63-69.
• [17]Suwanprathes P, Won C, Komoltri C, Nana A, Kotchabhakdi N, Guilleminault C: Epidemiology of sleep-related complaints associated with sleep-disordered breathing in Bangkok. Thailand. Sleep Med 2010, 11:1025-1030.
• [18]Khoo SM, Tan WC, Ng TP, Ho CH: Risk factors associated with habitual snoring and sleep-disordered breathing in a multi-ethnic Asian population: a population-based study. Respir Med 2004, 98:557-566.
• [19]Kamil MA, Teng CL, Hassan SA: Snoring and breathing pauses during sleep in the Malaysian population. Respirology 2007, 12:375-380.
• [20]Ip MS, Lam B, Lauder IJ, Tsang KW, Chung KF, Mok YW, Lam WK: A community study of sleep-disordered breathing in middle-aged Chinese men in Hong Kong. Chest 2001, 119:62-69.
• [21]Ip MS, Lam B, Tang LC, Lauder IJ, Ip TY, Lam WK: A community study of sleep-disordered breathing in middle-aged Chinese women in Hong Kong: prevalence and gender differences. Chest 2004, 125:127-134.
• [22]Hui DS, Ko FW, Chan JK, To KW, Fok JP, Ngai JC, Chan MC, Tung A, Chan DP, Ho CW, Lai CK: Sleep-disordered breathing and continuous positive airway pressure compliance in a group of commercial bus drivers in Hong Kong. Respirology 2006, 11:723-730.
• [23]He QY, Feng J, Zhang XL, Liang ZA, Huang SG, Kang J, Wang GF, Zhang LQ, Ma LJ, Wang B, Lin QC, Zhang JN, Liu HG, Luo YM, Liu JH, Wang S, Xiao GH, Lu G, Zhang J, Feng XW, Chen BY: Relationship of daytime blood pressure and severity of obstructive sleep apnea among Chinese: a multi-center investigation in China. Chin Med J (Engl) 2010, 123:18-22.
• [24]Chen R, Xiong KP, Lian YX, Huang JY, Zhao MY, Li JX, Liu CF: Daytime sleepiness and its determining factors in Chinese obstructive sleep apnea patients. Sleep Breath 2011, 15:129-135.
• [25]Tanigawa T, Tachibana N, Yamagishi K, Muraki I, Kudo M, Ohira T, Kitamura A, Sato S, Shimamoto T, Iso H: Relationship between sleep-disordered breathing and blood pressure levels in community-based samples of Japanese men. Hypertens Res 2004, 27:479-484.
• [26]Cui R, Tanigawa T, Sakurai S, Yamagishi K, Iso H: Relationships between sleep-disordered breathing and blood pressure and excessive daytime sleepiness among truck drivers. Hypertens Res 2006, 29:605-610.
• [27]Okabayashi K, Kasahara E, Uchiyama H, Yokota K, Togashi Y, Kono C, Yamada Y, Amano H, Yamaguchi T, Kawamoto T, Fujihara H, Ueta Y: Obstructive sleep apnea-hypopnea syndrome patients with overweight and hypertension in a Japanese workplace. J Occup Health 2007, 49:117-124.
• [28]Asaoka S, Namba K, Tsuiki S, Komada Y, Inoue Y: Excessive daytime sleepiness among Japanese public transportation drivers engaged in shiftwork. J Occup Environ Med 2010, 52:813-818.
• [29]Sharma SK, Kumpawat S, Banga A, Goel A: Prevalence and risk factors of obstructive sleep apnea syndrome in a population of Delhi. India. Chest 2006, 130:149-156.
• [30]Reddy EV, Kadhiravan T, Mishra HK, Sreenivas V, Handa KK, Sinha S, Sharma SK: Prevalence and risk factors of obstructive sleep apnea among middle-aged urban Indians: a community-based study. Sleep Med 2009, 10:913-918.
• [31]Kim J, In K, Kim J, You S, Kang K, Shim J, Lee S, Lee J, Lee S, Park C, Shin C: Prevalence of sleep-disordered breathing in middle-aged Korean men and women. Am J Respir Crit Care Med 2004, 170:1108-1113.
• [32]Yusoff MF, Baki MM, Mohamed N, Mohamed AS, Yunus MR, Ami M, Othman I, Ishak AI: Obstructive sleep apnea among express bus drivers in Malaysia: important indicators for screening. Traffic Inj Prev 2010, 11:594-599.
• [33]Puvanendran K, Goh KL: From snoring to sleep apnea in a Singapore population. Sleep Res Online 1999, 2:11-14.
• [34]Respirology 2010, 15(Suppl. 2):55-109. abstract PD 13–04
• [35]J Sleep Res. 2010., 2010Abstract Supplement. Abstract 0375
• [36]J Sleep Res. 2012., 35Abstract Supplement