Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis
Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis
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DOI：
10.1016/s2213-2600(19)30198-5
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发表时间：
2019-08-01
影响因子：
76.2
通讯作者：
Malhotra, Atul
中科院分区：
文献类型：
--
作者：
Benjafield, Adam V.;Ayas, Najib T.;Malhotra, Atul
阻塞性睡眠呼吸暂停是一种与主要神经认知和心血管后遗症相关的疾病，其全球患病率的公开数据很少。我们使用公开的数据，并联系主要意见领袖，估计阻塞性睡眠呼吸暂停的全球患病率。方法我们搜索PubMed和Embase，以确定已发表的研究报告阻塞性睡眠呼吸暂停的患病率的基础上客观的测试方法。为未使用美国睡眠医学学会（AASM）2012评分标准识别阻塞性睡眠呼吸暂停的研究创建了转换算法，允许为使用不同标准的出版物确定等效的呼吸暂停低通气指数（AHI）。由于参考研究和人群数据中有关症状的信息很少，因此未对症状的存在进行具体分析。使用新开发的算法对使用不同诊断标准的研究中阻塞性睡眠呼吸暂停的患病率估计进行标准化。将没有阻塞性睡眠呼吸暂停患病率数据的国家与有可用患病率数据的类似国家进行匹配;人群相似性基于人群体重指数、种族和地理邻近性。主要结果是阻塞性睡眠呼吸暂停的患病率基于AASM 2012年诊断标准的个人年龄在30-69岁（因为这个年龄组通常有可用的数据，在已发表的研究和相关的信息，从联合国为所有countries）。使用AASM 2012诊断标准和AHI阈值（每小时5起或更多事件和每小时15起或更多事件），我们估计有9.36亿人（95% CI 903-970）30-69岁成人（男性和女性）患有轻度至重度阻塞性睡眠呼吸暂停，4.25亿（399-450）30- 69岁，全球范围内有中度至重度阻塞性睡眠呼吸暂停。据我们所知，这是第一个报告阻塞性睡眠呼吸暂停全球患病率的研究;近10亿人受影响，在一些国家患病率超过50%，需要有效的诊断和治疗策略来最大限度地减少对健康的负面影响并最大限度地提高成本效益。版权所有（C）2019 Elsevier Ltd.保留所有权利。
Background There is a scarcity of published data on the global prevalence of obstructive sleep apnoea, a disorder associated with major neurocognitive and cardiovascular sequelae. We used publicly available data and contacted key opinion leaders to estimate the global prevalence of obstructive sleep apnoea.Methods We searched PubMed and Embase to identify published studies reporting the prevalence of obstructive sleep apnoea based on objective testing methods. A conversion algorithm was created for studies that did not use the American Academy of Sleep Medicine (AASM) 2012 scoring criteria to identify obstructive sleep apnoea, allowing determination of an equivalent apnoea-hypopnoea index (AHI) for publications that used different criteria. The presence of symptoms was not specifically analysed because of scarce information about symptoms in the reference studies and population data. Prevalence estimates for obstructive sleep apnoea across studies using different diagnostic criteria were standardised with a newly developed algorithm. Countries without obstructive sleep apnoea prevalence data were matched to a similar country with available prevalence data; population similarity was based on the population body-mass index, race, and geographical proximity. The primary outcome was prevalence of obstructive sleep apnoea based on AASM 2012 diagnostic criteria in individuals aged 30-69 years (as this age group generally had available data in the published studies and related to information from the UN for all countries).Findings Reliable prevalence data for obstructive sleep apnoea were available for 16 countries, from 17 studies. Using AASM 2012 diagnostic criteria and AHI threshold values of five or more events per h and 15 or more events per h, we estimated that 936 million (95% CI 903-970) adults aged 30-69 years (men and women) have mild to severe obstructive sleep apnoea and 425 million (399-450) adults aged 30-69 years have moderate to severe obstructive sleep apnoea globally. The number of affected individuals was highest in China, followed by the USA, Brazil, and India.Interpretation To our knowledge, this is the first study to report global prevalence of obstructive sleep apnoea; with almost 1 billion people affected, and with prevalence exceeding 50% in some countries, effective diagnostic and treatment strategies are needed to minimise the negative health impacts and to maximise cost-effectiveness. Copyright (C) 2019 Elsevier Ltd. All rights reserved.