Department on Global Health and Ecoepidemiology, Redavi Institute, Montréal, Canada.
Sleep Laboratory of Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro - Vila Real, Vila Real, Portugal.
Sleep Breath. 2021 Dec;25(4):1729-1739. doi: 10.1007/s11325-020-02274-z. Epub 2021 Jan 16.
Considering socioeconomic status (SES) in the diagnosis of obstructive sleep apnea (OSA) will enhance our understanding of socioeconomic disparities in clinical practice of sleep medicine. This systematic review analyzes the relations between SES and OSA measures.
Eleven articles were identified through the Pubmed database. The National Institute of Health's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to rate the quality of these studies.
This systematic review revealed that associations between socioeconomic status and OSA measures are similar for both adults, children, and adolescents. Our findings showed that: (1) A lower SES is associated with an increased risk of OSA, both in adults and children/adolescents as well as for men and women. (2) Several studies assessed sleep outcomes with a single question, an approach that is unable to capture the multi-dimensionality and day-to-day variability of sleep in general or OSA in particular, (3) Low SES has detrimental effects on sleep health. (4) Sleep questionnaires are more commonly used than objective measure to assess OSA.
Interaction between SES and OSA must be better understood to improve current clinical guidelines. Living conditions influence the trajectory of OSA with unknown speed and for an, undetermined period, pointing to the need for more studies on this topic. Future work should identify the effect of SES on the development and progression of OSA, determine the effect of behavioral intervention and local public health programs to reduce social inequalities associated with OSA.
考虑社会经济地位（SES）在阻塞性睡眠呼吸暂停（OSA）的诊断中，将有助于我们理解睡眠医学临床实践中的社会经济差异。本系统评价分析了 SES 与 OSA 测量之间的关系。
通过 Pubmed 数据库确定了 11 篇文章。使用美国国立卫生研究院的观察性队列和横断面研究质量评估工具对这些研究进行了质量评估。
本系统评价表明，SES 与 OSA 测量之间的关联在成人、儿童和青少年中相似。我们的研究结果表明：（1）较低的 SES 与 OSA 的风险增加有关，无论是在成人还是儿童/青少年中，无论是男性还是女性。（2）一些研究使用单一问题评估睡眠结果，这种方法无法捕捉到睡眠的多维性和日常变化，特别是 OSA。（3）较低的 SES 对睡眠健康有不利影响。（4）睡眠问卷比客观测量更常用于评估 OSA。
为了改进现有的临床指南，必须更好地理解 SES 和 OSA 之间的相互作用。生活条件影响 OSA 的轨迹，其速度和持续时间未知，这表明需要对此主题进行更多的研究。未来的工作应确定 SES 对 OSA 的发展和进展的影响，确定行为干预和地方公共卫生计划对减少与 OSA 相关的社会不平等的影响。
