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An Estimate of the Global Prevalence and Burden of Obstructive Sleep Apnoea

45 Pages Posted: 10 Jan 2019

See all articles by Adam Benjafield

Adam Benjafield

ResMed Science Center

Najib T. Ayas

University of British Columbia (UBC) - Department of Medicine

Peter R. Eastwood

The University of Western Australia

Raphael Heinzer

University of Lausanne

Mary SM Ip

The University of Hong Kong

Mary J. Morrell

Imperial College London - National Heart and Lung Institute

Carlos M. Nunez

ResMed Science Center

Sanjay R. Patel

University of Pittsburgh, School of Medicine, Center for Sleep and Cardiovascular Outcomes Research

Thomas Penzel

Charité - Universitätsmedizin Berlin

Jean-Louis D. Pépin

University Grenoble Alpes

Paul E. Peppard

University of Wisconsin - Madison - Department of Population Health Sciences

Sanjeev Sinha

All India Institute of Medical Sciences (AIIMS)

Sergio Tufik

Federal University of São Paulo (Unifesp)

Kate Valentine

ResMed Science Center

Atul Malhotra

University of California, San Diego (UCSD)

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Abstract

Background: There is a lack of published data on the global prevalence of obstructive sleep apnoea (OSA), a disease associated with major neurocognitive and cardiovascular sequelae. We used publicly available data and contacted key opinion leaders to estimate the global prevalence of OSA.

Methods: A PubMed search was conducted to identify published studies reporting OSA prevalence based on objective testing. Symptoms were not specifically evaluated due to a lack of information about symptoms in the reference studies and population data. An algorithm was developed to standardise prevalence rates across studies using different diagnostic criteria. Countries without data were matched to a similar country with data; population similarity was based on the population body mass index, race, and geographic proximity.

Findings: Reliable prevalence data for OSA were available for 16 countries (17 studies). Using American Academy of Sleep Medicine (AASM) diagnostic criteria and apnoea-hypopnea index (AHI) threshold values of =5/h and =15/h, we estimated that 936 million (95% confidence interval [CI] 903 million to 970 million) and 425 million (95% CI 399 million to 450 million) adults aged 30-69 years (males and females) have mild-to-severe OSA and moderate to severe OSA, respectively. The number of affected individuals was highest in China, followed by the US, Brazil and India.

Interpretation: Nearly 1 billion middle-aged adults worldwide have OSA. The number of people with moderate to severe OSA, in whom treatment is generally recommended, is nearly 425 million. These numbers highlight the importance of strategies to diagnose and treat OSA effectively.

Funding Statement: ResMed

Declaration of Interests: AVB, KV, and CMN are employees of ResMed. NTA reports being on the advisory board of Bresotec. PRE is supported in part from a Senior Research Fellowship from the NHMRC (No. 1042341). RH reports grants from the Swiss National Science Foundation (grants 3200B0-105993, 3200B0-118308, 33CSCO122661, 33CS30-139468 and 33CS30-148401), the Leenaards Foundation, the Ligue Pulmonaire Vaudoise, GlaxoSmithKline and the Faculty of Biology and Medicine of Lausanne University, and personal fees for medical advisory board work from Nightbalance. MSMI reports no conflicts of interest. MJM reports being principal investigator on a multicentre trial funded by ResMed. SRP reports having received grant funding through his institution from the American Sleep Medicine Foundation, the ResMed Foundation, Bayer Pharmaceuticals and Philips Respironics. TP reports personal funding by ICRC St. Anne Hospital Brno Czech Republic, and institutional funding by Heel, Bioprojet, ResMed, Philips Respironics, and Löwenstein Medical Technology. JLP is supported by a research grant from the French National Research Agency (ANR-12-TECS-0010), in the framework of the “Investissements d’avenir” program (ANR-15-IDEX-02) and reports participation in medXcloud an academic and industry partnership sponsored by ResMed. PEP reports no conflicts of interest. SS reports no conflicts of interest. ST reports no conflicts of interest. AM relinquished all outside personal income as an Officer of the American Thoracic Society in 2012. ResMed provided a philanthropic donation to UC San Diego and reports participation in medXcloud an academic and industry partnership sponsored by ResMed.

Keywords: Sleep apnoea, Epidemiology

Suggested Citation

Benjafield, Adam and Ayas, Najib T. and Eastwood, Peter R. and Heinzer, Raphael and Ip, Mary SM and Morrell, Mary J. and Nunez, Carlos M. and Patel, Sanjay R. and Penzel, Thomas and Pépin, Jean-Louis D. and Peppard, Paul E. and Sinha, Sanjeev and Tufik, Sergio and Valentine, Kate and Malhotra, Atul, An Estimate of the Global Prevalence and Burden of Obstructive Sleep Apnoea (March 1, 2019). Available at SSRN: https://ssrn.com/abstract=3310634

Adam Benjafield (Contact Author)

ResMed Science Center ( email )

San Diego, CA 92093
United States

Najib T. Ayas

University of British Columbia (UBC) - Department of Medicine

2775 Laurel Street, 10th Floor
Vancouver, British Columbia V5Z 1M9
Canada

Peter R. Eastwood

The University of Western Australia

35 Stirling Highway
Crawley, Western Australia 6009
Australia

Raphael Heinzer

University of Lausanne

Lausanne, Vaud CH-1015
Switzerland

Mary SM Ip

The University of Hong Kong

Pokfulam Road
Hong Kong, Pokfulam HK
China

Mary J. Morrell

Imperial College London - National Heart and Lung Institute

Guy Scadding Building, Cale Street
London, SW3 6LY
United Kingdom

Carlos M. Nunez

ResMed Science Center

San Diego, CA 92093
United States

Sanjay R. Patel

University of Pittsburgh, School of Medicine, Center for Sleep and Cardiovascular Outcomes Research ( email )

PA
United States

Thomas Penzel

Charité - Universitätsmedizin Berlin

Charitéplatz 1
Berlin, 10117
Germany

Jean-Louis D. Pépin

University Grenoble Alpes

151 Rue des Universités
Saint-Martin-d'Hères, 38400
France

Paul E. Peppard

University of Wisconsin - Madison - Department of Population Health Sciences

610 Walnut St
Madison, WI 53726
United States

Sanjeev Sinha

All India Institute of Medical Sciences (AIIMS)

Aurobindo Marg
Ansari Nagar East
New Delhi, New Delhi 110029
India

Sergio Tufik

Federal University of São Paulo (Unifesp)

Rua Sena Madureira, 1500 - 5º andar
Vila Clementino
São Paulo, Sao Paulo 04021001
Brazil

Kate Valentine

ResMed Science Center

San Diego, CA 92093
United States

Atul Malhotra

University of California, San Diego (UCSD) ( email )

9500 Gilman Drive
Mail Code 0502
La Jolla, CA 92093-0112
United States

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