School of Population and Global Health, The University of Melbourne, Melbourne, Australia; Department of Community Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
School of Population and Global Health, The University of Melbourne, Melbourne, Australia; The Institute for Breathing & Sleep, Heidelberg, Melbourne, Australia.
Sleep Med Rev. 2017 Aug;34:70-81. doi: 10.1016/j.smrv.2016.07.002. Epub 2016 Jul 18.
With this systematic review we aimed to determine the prevalence of obstructive sleep apnea (OSA) in adults in the general population and how it varied between population sub-groups. Twenty-four studies out of 3807 found by systematically searching PubMed and Embase databases were included in this review. Substantial methodological heterogeneity in population prevalence studies has caused a wide variation in the reported prevalence, which, in general, is high. At ≥5 events/h apnea-hypopnea index (AHI), the overall population prevalence ranged from 9% to 38% and was higher in men. It increased with increasing age and, in some elderly groups, was as high as 90% in men and 78% in women. At ≥15 events/h AHI, the prevalence in the general adult population ranged from 6% to 17%, being as high as 49% in the advanced ages. OSA prevalence was also greater in obese men and women. This systematic review of the overall body of evidence confirms that advancing age, male sex, and higher body-mass index increase OSA prevalence. The need to a) consider OSA as having a continuum in the general population and b) generate consensus on methodology and diagnostic threshold to define OSA so that the prevalence of OSA can be validly compared across regions and countries, and within age-/sex-specific subgroups, is highlighted.
本系统评价旨在确定普通人群中成年人阻塞性睡眠呼吸暂停（OSA）的患病率，以及其在人群亚组之间的差异。通过系统搜索 PubMed 和 Embase 数据库，从 3807 项研究中找到了 24 项研究，这些研究被纳入了本综述。人群患病率研究中存在大量方法学上的异质性，导致报告的患病率差异很大，总体上患病率较高。在呼吸暂停低通气指数（AHI）≥5 次/小时时，总体人群患病率范围为 9%至 38%，男性患病率较高。它随着年龄的增加而增加，在一些老年人群中，男性高达 90%，女性高达 78%。在 AHI≥15 次/小时时，普通成年人群的患病率范围为 6%至 17%，在高龄人群中患病率高达 49%。OSA 的患病率在肥胖的男性和女性中也更高。对现有证据的全面系统评价证实，年龄增长、男性性别和更高的体重指数会增加 OSA 的患病率。需要：a）将 OSA 视为普通人群中的一种连续状态；b）就方法学和诊断阈值达成共识，以定义 OSA，以便能够在不同地区和国家之间，以及在年龄/性别特定亚组内，对 OSA 的患病率进行有效比较。
