The Epidemiology of Adult Obstructive Sleep Apnea

Abstract

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 bedpartner 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.Keywords: obstructive sleep apnea; sleep-disordered breathing; epidemiology Obstructive sleep apnea is being increasingly recognized as an important cause of medical morbidity and mortality. It is a relatively common sleep disorder that is characterized by recurrent episodes of partial or complete collapse of the upper airway during sleep. The ensuing reduction of airflow often leads to acute derangements in gas exchange and recurrent arousals from sleep. The health consequences of obstructive sleep apnea are numerous. If left untreated, it leads to excessive daytime sleepiness, cognitive dysfunction, impaired work performance, and decrements in health-related quality of life. Observational and experimental evidence also suggests that obstructive sleep apnea may contribute to the development of systemic hypertension (1), cardiovascular disease (2), and abnormalities in glucose metabolism (3). Obstructive sleep apnea is insidious and patients are often unaware of the associated symptoms. Cardinal manifestations include loud snoring, witnessed breathing pauses during sleep, fitful sleep quality, and excessive daytime sleepiness. Early recognition and appropriate therapy can ameliorate the neurobehavioral consequences and may also have favorable effects on cardiovascular health (4).Clinical descriptions of obstructive sleep apnea can be found in numerous reports published in the medical literature over the last century (5). However, it was not until the 1980s that the clinical ramifications of disorder became more widely appreciated by the medical community. Although public awareness of obstructive sleep apnea has steadily increased since then, a majority of those affected still remain undiagnosed. Thus, primary care physicians and specialists...

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“…To ensure the accuracy and consistency of analyzing, 50% of all studies will be audited by a masked investigator with expertise in sleep medical. Recruited patients were classified into OSA (AHI ≥15 events/hour) and non‐OSA (AHI <15 events/hour) groups 5, 13…”

Impact of obstructive sleep apnea on cognitive performance

“…The prevalence of OSA is estimated to range from 2% to 4% of the population aged 30 to 60 years, according to the first major US population-based study con-Obs tructive sleep apnea: cognitive performance Bawden et al ducted in 1993 [6][7][8] . Risk factors include advanced age, male gender, obesity and craniofacial morphology [6][7][8] .…”

“…Risk factors include advanced age, male gender, obesity and craniofacial morphology [6][7][8] . The nightly use of positive pressure in the upper airway provided by Continuous Positive Airway Pressure (CPAP) or Bilevel Positive Airway Pressure (BiPAP) is the most effective treatment of OSA.…”

Patient and provider perceptions of sleep disordered breathing assessment during prenatal care: a survey-based observational study

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