Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2013

Open Access 01-12-2013 | Research article

Prevalence of obstructive sleep apnea in Asian adults: a systematic review of the literature

Authors: Aibek E Mirrakhimov, Talant Sooronbaev, Erkin M Mirrakhimov

Published in: BMC Pulmonary Medicine | Issue 1/2013

Login to get access

Abstract

Background

Obstructive sleep apnea (OSA) is a common disease, affecting approximately 2% of women and 4% of men residing in Western communities. No systematically reviewed data are available about the prevalence of this disease in Asia, the most heavily populated continent.

Methods

PubMed/Medline, Scopus and Google Scholar were searched for articles published from 1993 to May 2012 that reported the prevalence of OSA diagnosed via sleep monitoring and the prevalence of patients at risk for OSA as assessed by symptomatology and/or sleep questionnaires. We have also searched abstract database of major pulmonary and sleep scientific societies for relevant abstracts presented from 2010 to 2012. The following inclusion criteria were used: articles published in English, age ≥ 18 years, ≥ 100 participants in studies using sleep monitoring for the diagnosis of OSA, ≥ 300 participants in studies using questionnaires to detect patients at high risk for OSA. Exclusion criteria: duplicate publications, studies reporting the prevalence of central sleep apnea only, hospital based studies as well as studies assessing OSA prevalence among patients with resistant arterial hypertension, chronic kidney disease, heart failure and in patients with concomitant neurological disease.

Results

Twenty four articles were found to meet the inclusion criteria, covering 47,957 subjects (26,042 men and 21,915 women) and four relevant abstracts were noted. OSA prevalence ranged from 3.7% to 97.3%. Male gender, older age, a higher BMI and waist to hip ratio, greater neck circumference, arterial hypertension, smoking, snoring and daytime sleepiness were associated with OSA. Sample size, difference between the populations studied and the fact that some works included patients with a high pre-test probability of OSA explain the difference in prevalence rates.

Conclusion

This systematic review highlights the lack of data regarding the prevalence of OSA in Asians. Only a few studies provide an approximate estimate of the OSA burden in some Asian communities.
Appendix
Available only for authorised users
Literature
1.
go back to reference Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The report of an American Academy of Sleep Medicine Task force. Sleep. 1999, 22: 667-689. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The report of an American Academy of Sleep Medicine Task force. Sleep. 1999, 22: 667-689.
2.
go back to reference Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP: Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999, 131: 485-491.CrossRefPubMed Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP: Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999, 131: 485-491.CrossRefPubMed
3.
go back to reference Johns MW: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991, 14: 540-545.PubMed Johns MW: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991, 14: 540-545.PubMed
4.
go back to reference Eastwood PR, Malhotra A, Palmer LJ, Kezirian EJ, Horner RL, Ip MS, Thurnheer R, Antic NA, Hillman DR: Obstructive Sleep Apnoea: From pathogenesis to treatment: Current controversies and future directions. Respirology. 2010, 15: 587-595. 10.1111/j.1440-1843.2009.01699.x.CrossRefPubMedPubMedCentral Eastwood PR, Malhotra A, Palmer LJ, Kezirian EJ, Horner RL, Ip MS, Thurnheer R, Antic NA, Hillman DR: Obstructive Sleep Apnoea: From pathogenesis to treatment: Current controversies and future directions. Respirology. 2010, 15: 587-595. 10.1111/j.1440-1843.2009.01699.x.CrossRefPubMedPubMedCentral
5.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009, 6 (7): e1000097-10.1371/journal.pmed.1000097.CrossRefPubMedPubMedCentral Moher D, Liberati A, Tetzlaff J, Altman DG: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009, 6 (7): e1000097-10.1371/journal.pmed.1000097.CrossRefPubMedPubMedCentral
6.
go back to reference Dudenbostel T, Calhoun DA: Resistant hypertension, obstructive sleep apnoea and aldosterone. J Hum Hypertens. 2012, 26: 281-287. 10.1038/jhh.2011.47.CrossRefPubMed Dudenbostel T, Calhoun DA: Resistant hypertension, obstructive sleep apnoea and aldosterone. J Hum Hypertens. 2012, 26: 281-287. 10.1038/jhh.2011.47.CrossRefPubMed
7.
go back to reference Kasai T, Bradley TD: Obstructive sleep apnea and heart failure: pathophysiologic and therapeutic implications. J Am Coll Cardiol. 2011, 57: 119-127. 10.1016/j.jacc.2010.08.627.CrossRefPubMed Kasai T, Bradley TD: Obstructive sleep apnea and heart failure: pathophysiologic and therapeutic implications. J Am Coll Cardiol. 2011, 57: 119-127. 10.1016/j.jacc.2010.08.627.CrossRefPubMed
8.
go back to reference Mirrakhimov AE: Sleep Breath. Obstructive sleep apnea and kidney disease: is there any direct link?. 2011, [Epub ahead of print]. PMID: 22170216 Mirrakhimov AE: Sleep Breath. Obstructive sleep apnea and kidney disease: is there any direct link?. 2011, [Epub ahead of print]. PMID: 22170216
10.
go back to reference Ozdemir L, Akkurt I, Sümer H, Cetinkaya S, Gönlügür U, Ozşahin SL, Nur N, Doğan O: The prevalence of sleep related disorders in Sivas. Turkey. Tuberk Toraks. 2005, 53: 20-27.PubMed Ozdemir L, Akkurt I, Sümer H, Cetinkaya S, Gönlügür U, Ozşahin SL, Nur N, Doğan O: The prevalence of sleep related disorders in Sivas. Turkey. Tuberk Toraks. 2005, 53: 20-27.PubMed
11.
go back to reference Kart L, Dutkun Y, Altın R, Ornek T, Kıran S: Prevalence of major obstructive sleep apnea syndrome symptoms in coal miners and healthy adults. Tuberk Toraks. 2010, 58: 261-267.PubMed Kart L, Dutkun Y, Altın R, Ornek T, Kıran S: Prevalence of major obstructive sleep apnea syndrome symptoms in coal miners and healthy adults. Tuberk Toraks. 2010, 58: 261-267.PubMed
12.
go back to reference Liu SA, Liu CY: Prevalence of snoring in Taichung area: an epidemiological study. J Chin Med Assoc. 2004, 67: 32-36.PubMed Liu SA, Liu CY: Prevalence of snoring in Taichung area: an epidemiological study. J Chin Med Assoc. 2004, 67: 32-36.PubMed
13.
go back to reference Chuang LP, Hsu SC, Lin SW, Ko WS, Chen NH, Tsai YH: Prevalence of snoring and witnessed apnea in Taiwanese adults. Chang Gung Med J. 2008, 31: 175-181.PubMed Chuang LP, Hsu SC, Lin SW, Ko WS, Chen NH, Tsai YH: Prevalence of snoring and witnessed apnea in Taiwanese adults. Chang Gung Med J. 2008, 31: 175-181.PubMed
14.
go back to reference Amra B, Farajzadegan Z, Golshan M, Fietze I, Penzel T: Prevalence of sleep apnea-related symptoms in a Persian population. Sleep Breath. 2011, 15: 425-429. 10.1007/s11325-010-0353-4.CrossRefPubMed Amra B, Farajzadegan Z, Golshan M, Fietze I, Penzel T: Prevalence of sleep apnea-related symptoms in a Persian population. Sleep Breath. 2011, 15: 425-429. 10.1007/s11325-010-0353-4.CrossRefPubMed
15.
go back to reference Khazaie H, Najafi F, Rezaie L, Tahmasian M, Sepehry AA, Herth FJ: Prevalence of symptoms and risk of obstructive sleep apnea syndrome in the general population. Arch Iran Med. 2011, 14: 335-338.PubMed Khazaie H, Najafi F, Rezaie L, Tahmasian M, Sepehry AA, Herth FJ: Prevalence of symptoms and risk of obstructive sleep apnea syndrome in the general population. Arch Iran Med. 2011, 14: 335-338.PubMed
16.
go back to reference Nagayoshi M, Yamagishi K, Tanigawa T, Sakurai S, Kitamura A, Kiyama M, Imano H, Ohira T, Sato S, Sankai T, Iso H: Risk factors for snoring among Japanese men and women: a community-based cross-sectional study. Sleep Breath. 2011, 15: 63-69. 10.1007/s11325-009-0319-6.CrossRefPubMed Nagayoshi M, Yamagishi K, Tanigawa T, Sakurai S, Kitamura A, Kiyama M, Imano H, Ohira T, Sato S, Sankai T, Iso H: Risk factors for snoring among Japanese men and women: a community-based cross-sectional study. Sleep Breath. 2011, 15: 63-69. 10.1007/s11325-009-0319-6.CrossRefPubMed
17.
go back to reference Suwanprathes P, Won C, Komoltri C, Nana A, Kotchabhakdi N, Guilleminault C: Epidemiology of sleep-related complaints associated with sleep-disordered breathing in Bangkok. Thailand. Sleep Med. 2010, 11: 1025-1030. 10.1016/j.sleep.2010.04.007.CrossRefPubMed Suwanprathes P, Won C, Komoltri C, Nana A, Kotchabhakdi N, Guilleminault C: Epidemiology of sleep-related complaints associated with sleep-disordered breathing in Bangkok. Thailand. Sleep Med. 2010, 11: 1025-1030. 10.1016/j.sleep.2010.04.007.CrossRefPubMed
18.
go back to reference Khoo SM, Tan WC, Ng TP, Ho CH: Risk factors associated with habitual snoring and sleep-disordered breathing in a multi-ethnic Asian population: a population-based study. Respir Med. 2004, 98: 557-566. 10.1016/j.rmed.2003.11.017.CrossRefPubMed Khoo SM, Tan WC, Ng TP, Ho CH: Risk factors associated with habitual snoring and sleep-disordered breathing in a multi-ethnic Asian population: a population-based study. Respir Med. 2004, 98: 557-566. 10.1016/j.rmed.2003.11.017.CrossRefPubMed
19.
go back to reference Kamil MA, Teng CL, Hassan SA: Snoring and breathing pauses during sleep in the Malaysian population. Respirology. 2007, 12: 375-380. 10.1111/j.1440-1843.2007.01030.x.CrossRefPubMed Kamil MA, Teng CL, Hassan SA: Snoring and breathing pauses during sleep in the Malaysian population. Respirology. 2007, 12: 375-380. 10.1111/j.1440-1843.2007.01030.x.CrossRefPubMed
20.
go back to reference Ip MS, Lam B, Lauder IJ, Tsang KW, Chung KF, Mok YW, Lam WK: A community study of sleep-disordered breathing in middle-aged Chinese men in Hong Kong. Chest. 2001, 119: 62-69. 10.1378/chest.119.1.62.CrossRefPubMed Ip MS, Lam B, Lauder IJ, Tsang KW, Chung KF, Mok YW, Lam WK: A community study of sleep-disordered breathing in middle-aged Chinese men in Hong Kong. Chest. 2001, 119: 62-69. 10.1378/chest.119.1.62.CrossRefPubMed
21.
go back to reference Ip MS, Lam B, Tang LC, Lauder IJ, Ip TY, Lam WK: A community study of sleep-disordered breathing in middle-aged Chinese women in Hong Kong: prevalence and gender differences. Chest. 2004, 125: 127-134. 10.1378/chest.125.1.127.CrossRefPubMed Ip MS, Lam B, Tang LC, Lauder IJ, Ip TY, Lam WK: A community study of sleep-disordered breathing in middle-aged Chinese women in Hong Kong: prevalence and gender differences. Chest. 2004, 125: 127-134. 10.1378/chest.125.1.127.CrossRefPubMed
22.
go back to reference Hui DS, Ko FW, Chan JK, To KW, Fok JP, Ngai JC, Chan MC, Tung A, Chan DP, Ho CW, Lai CK: Sleep-disordered breathing and continuous positive airway pressure compliance in a group of commercial bus drivers in Hong Kong. Respirology. 2006, 11: 723-730. 10.1111/j.1440-1843.2006.00932.x.CrossRefPubMed Hui DS, Ko FW, Chan JK, To KW, Fok JP, Ngai JC, Chan MC, Tung A, Chan DP, Ho CW, Lai CK: Sleep-disordered breathing and continuous positive airway pressure compliance in a group of commercial bus drivers in Hong Kong. Respirology. 2006, 11: 723-730. 10.1111/j.1440-1843.2006.00932.x.CrossRefPubMed
23.
go back to reference He QY, Feng J, Zhang XL, Liang ZA, Huang SG, Kang J, Wang GF, Zhang LQ, Ma LJ, Wang B, Lin QC, Zhang JN, Liu HG, Luo YM, Liu JH, Wang S, Xiao GH, Lu G, Zhang J, Feng XW, Chen BY: Relationship of daytime blood pressure and severity of obstructive sleep apnea among Chinese: a multi-center investigation in China. Chin Med J (Engl). 2010, 123: 18-22. He QY, Feng J, Zhang XL, Liang ZA, Huang SG, Kang J, Wang GF, Zhang LQ, Ma LJ, Wang B, Lin QC, Zhang JN, Liu HG, Luo YM, Liu JH, Wang S, Xiao GH, Lu G, Zhang J, Feng XW, Chen BY: Relationship of daytime blood pressure and severity of obstructive sleep apnea among Chinese: a multi-center investigation in China. Chin Med J (Engl). 2010, 123: 18-22.
24.
go back to reference Chen R, Xiong KP, Lian YX, Huang JY, Zhao MY, Li JX, Liu CF: Daytime sleepiness and its determining factors in Chinese obstructive sleep apnea patients. Sleep Breath. 2011, 15: 129-135. 10.1007/s11325-010-0337-4.CrossRefPubMed Chen R, Xiong KP, Lian YX, Huang JY, Zhao MY, Li JX, Liu CF: Daytime sleepiness and its determining factors in Chinese obstructive sleep apnea patients. Sleep Breath. 2011, 15: 129-135. 10.1007/s11325-010-0337-4.CrossRefPubMed
25.
go back to reference Tanigawa T, Tachibana N, Yamagishi K, Muraki I, Kudo M, Ohira T, Kitamura A, Sato S, Shimamoto T, Iso H: Relationship between sleep-disordered breathing and blood pressure levels in community-based samples of Japanese men. Hypertens Res. 2004, 27: 479-484. 10.1291/hypres.27.479.CrossRefPubMed Tanigawa T, Tachibana N, Yamagishi K, Muraki I, Kudo M, Ohira T, Kitamura A, Sato S, Shimamoto T, Iso H: Relationship between sleep-disordered breathing and blood pressure levels in community-based samples of Japanese men. Hypertens Res. 2004, 27: 479-484. 10.1291/hypres.27.479.CrossRefPubMed
26.
go back to reference Cui R, Tanigawa T, Sakurai S, Yamagishi K, Iso H: Relationships between sleep-disordered breathing and blood pressure and excessive daytime sleepiness among truck drivers. Hypertens Res. 2006, 29: 605-610. 10.1291/hypres.29.605.CrossRefPubMed Cui R, Tanigawa T, Sakurai S, Yamagishi K, Iso H: Relationships between sleep-disordered breathing and blood pressure and excessive daytime sleepiness among truck drivers. Hypertens Res. 2006, 29: 605-610. 10.1291/hypres.29.605.CrossRefPubMed
27.
go back to reference Okabayashi K, Kasahara E, Uchiyama H, Yokota K, Togashi Y, Kono C, Yamada Y, Amano H, Yamaguchi T, Kawamoto T, Fujihara H, Ueta Y: Obstructive sleep apnea-hypopnea syndrome patients with overweight and hypertension in a Japanese workplace. J Occup Health. 2007, 49: 117-124. 10.1539/joh.49.117.CrossRefPubMed Okabayashi K, Kasahara E, Uchiyama H, Yokota K, Togashi Y, Kono C, Yamada Y, Amano H, Yamaguchi T, Kawamoto T, Fujihara H, Ueta Y: Obstructive sleep apnea-hypopnea syndrome patients with overweight and hypertension in a Japanese workplace. J Occup Health. 2007, 49: 117-124. 10.1539/joh.49.117.CrossRefPubMed
28.
go back to reference Asaoka S, Namba K, Tsuiki S, Komada Y, Inoue Y: Excessive daytime sleepiness among Japanese public transportation drivers engaged in shiftwork. J Occup Environ Med. 2010, 52: 813-818. 10.1097/JOM.0b013e3181ea5a67.CrossRefPubMed Asaoka S, Namba K, Tsuiki S, Komada Y, Inoue Y: Excessive daytime sleepiness among Japanese public transportation drivers engaged in shiftwork. J Occup Environ Med. 2010, 52: 813-818. 10.1097/JOM.0b013e3181ea5a67.CrossRefPubMed
29.
go back to reference Sharma SK, Kumpawat S, Banga A, Goel A: Prevalence and risk factors of obstructive sleep apnea syndrome in a population of Delhi. India. Chest. 2006, 130: 149-156. 10.1378/chest.130.1.149.CrossRefPubMed Sharma SK, Kumpawat S, Banga A, Goel A: Prevalence and risk factors of obstructive sleep apnea syndrome in a population of Delhi. India. Chest. 2006, 130: 149-156. 10.1378/chest.130.1.149.CrossRefPubMed
30.
go back to reference Reddy EV, Kadhiravan T, Mishra HK, Sreenivas V, Handa KK, Sinha S, Sharma SK: Prevalence and risk factors of obstructive sleep apnea among middle-aged urban Indians: a community-based study. Sleep Med. 2009, 10: 913-918. 10.1016/j.sleep.2008.08.011.CrossRefPubMed Reddy EV, Kadhiravan T, Mishra HK, Sreenivas V, Handa KK, Sinha S, Sharma SK: Prevalence and risk factors of obstructive sleep apnea among middle-aged urban Indians: a community-based study. Sleep Med. 2009, 10: 913-918. 10.1016/j.sleep.2008.08.011.CrossRefPubMed
31.
go back to reference Kim J, In K, Kim J, You S, Kang K, Shim J, Lee S, Lee J, Lee S, Park C, Shin C: Prevalence of sleep-disordered breathing in middle-aged Korean men and women. Am J Respir Crit Care Med. 2004, 170: 1108-1113. 10.1164/rccm.200404-519OC.CrossRefPubMed Kim J, In K, Kim J, You S, Kang K, Shim J, Lee S, Lee J, Lee S, Park C, Shin C: Prevalence of sleep-disordered breathing in middle-aged Korean men and women. Am J Respir Crit Care Med. 2004, 170: 1108-1113. 10.1164/rccm.200404-519OC.CrossRefPubMed
32.
go back to reference Yusoff MF, Baki MM, Mohamed N, Mohamed AS, Yunus MR, Ami M, Othman I, Ishak AI: Obstructive sleep apnea among express bus drivers in Malaysia: important indicators for screening. Traffic Inj Prev. 2010, 11: 594-599. 10.1080/15389588.2010.505255.CrossRefPubMed Yusoff MF, Baki MM, Mohamed N, Mohamed AS, Yunus MR, Ami M, Othman I, Ishak AI: Obstructive sleep apnea among express bus drivers in Malaysia: important indicators for screening. Traffic Inj Prev. 2010, 11: 594-599. 10.1080/15389588.2010.505255.CrossRefPubMed
33.
go back to reference Puvanendran K, Goh KL: From snoring to sleep apnea in a Singapore population. Sleep Res Online. 1999, 2: 11-14.PubMed Puvanendran K, Goh KL: From snoring to sleep apnea in a Singapore population. Sleep Res Online. 1999, 2: 11-14.PubMed
34.
go back to reference Respirology. 2010, 15 (Suppl. 2): 55-109. abstract PD 13–04 Respirology. 2010, 15 (Suppl. 2): 55-109. abstract PD 13–04
35.
go back to reference J Sleep Res. 2010, 2010: Abstract Supplement. Abstract 0375 J Sleep Res. 2010, 2010: Abstract Supplement. Abstract 0375
36.
Metadata
Title
Prevalence of obstructive sleep apnea in Asian adults: a systematic review of the literature
Authors
Aibek E Mirrakhimov
Talant Sooronbaev
Erkin M Mirrakhimov
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2013
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/1471-2466-13-10

Other articles of this Issue 1/2013

BMC Pulmonary Medicine 1/2013 Go to the issue