TY - JOUR
T1 - Longitudinal risk factors for obstructive sleep apnea
T2 - A systematic review
AU - Qian, Yaoyao
AU - Dharmage, Shyamali C.
AU - Hamilton, Garun S.
AU - Lodge, Caroline J.
AU - Lowe, Adrian J.
AU - Zhang, Jingwen
AU - Bowatte, Gayan
AU - Perret, Jennifer L.
AU - Senaratna, Chamara V.
N1 - Funding Information:
Medline (on OVID) and Embase databases were systematically searched using a pre-defined search strategy for original studies. We applied keywords to define OSA and probable OSA, OSA assessment methods, and study designs (Table S1 in the supporting information). Reference lists of articles were screened to identify any additional studies that were not captured using the search strategy. The search was first conducted on 28 February 2022 and updated on 11 January 2023.We excluded studies that did not consider risk factors, only assessed biomarkers of OSA (indicators about physiological and biological processes), were based on clinical or specialty populations, were not performed among human adults, published only the abstracts, or published in a language other than English (Table S2 in the supporting information).Ten studies had good quality as per NOS (overall score of at least seven out of nine), while one scored five (Table S5 in the supporting information [27]). Associations found in these ten studies had been adjusted for at least two important confounders based on current literature, including adjustments for age, weight/BMI and/or sex. All studies had relatively long follow-up periods (range 4–35 years). The retention rate of participants was more than 60% in seven studies [28,30-34,36] and ranged from 28% to 39% in others [27,29,35,37].G.S.H has received equipment to support research from ResMed and Air Liquide Healthcare. S.C.D., C.J.L., J.L.P and A.J.L. declare they have received research funds from GSK's competitively awarded Investigator Sponsored Studies program, for unrelated research. A.J.L & S.C.D have received grant funding from Sanofi Regeneron for unrelated research. A.J.L. has also received donations of interventional product (EpiCeram) from Primus Pharmaceuticals for unrelated research.
Publisher Copyright:
© 2023 The Authors
PY - 2023/10
Y1 - 2023/10
N2 - Despite substantial disease burden, existing evidence on the risk factors for obstructive sleep apnea (OSA) have been derived primarily from cross-sectional studies without determining temporality. Therefore, we aimed to systematically synthesize the literature on longitudinal risk factors for sleep study-assessed OSA and questionnaire-assessed probable OSA from cohort studies in the general adult population settings. We systematically searched Embase and Medline (on OVID) databases. Eleven studies met the inclusion criteria. Meta-analyses were not conducted due to methodological heterogeneity of exposure and outcome measurements. There was consistent evidence that weight gain was associated with incident (n = 2) and greater severity (n = 2) of OSA. One study each observed an association of higher baseline body-mass index, male sex, asthma, a specific genetic polymorphism in rs12415421, and insulin resistance/hyperglycemia, with incident OSA. Long-term exposure to ambient air pollution (NO2, n = 1) was associated with OSA, and menopausal transitions (n = 1) with higher apnea-hypopnea index. There were no eligible studies on long-term smoking or alcohol use. In conclusion, approximately 10% increase in weight, especially in males, might alert clinicians to consider potential or worsening OSA. Large, well-designed longitudinal studies are needed to consolidate knowledge on other associations with OSA development, especially on potentially modifiable risk factors.
AB - Despite substantial disease burden, existing evidence on the risk factors for obstructive sleep apnea (OSA) have been derived primarily from cross-sectional studies without determining temporality. Therefore, we aimed to systematically synthesize the literature on longitudinal risk factors for sleep study-assessed OSA and questionnaire-assessed probable OSA from cohort studies in the general adult population settings. We systematically searched Embase and Medline (on OVID) databases. Eleven studies met the inclusion criteria. Meta-analyses were not conducted due to methodological heterogeneity of exposure and outcome measurements. There was consistent evidence that weight gain was associated with incident (n = 2) and greater severity (n = 2) of OSA. One study each observed an association of higher baseline body-mass index, male sex, asthma, a specific genetic polymorphism in rs12415421, and insulin resistance/hyperglycemia, with incident OSA. Long-term exposure to ambient air pollution (NO2, n = 1) was associated with OSA, and menopausal transitions (n = 1) with higher apnea-hypopnea index. There were no eligible studies on long-term smoking or alcohol use. In conclusion, approximately 10% increase in weight, especially in males, might alert clinicians to consider potential or worsening OSA. Large, well-designed longitudinal studies are needed to consolidate knowledge on other associations with OSA development, especially on potentially modifiable risk factors.
KW - Cohort
KW - General population
KW - Longitudinal studies
KW - Obstructive sleep apnea
KW - Risk factors
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85169068391&partnerID=8YFLogxK
U2 - 10.1016/j.smrv.2023.101838
DO - 10.1016/j.smrv.2023.101838
M3 - Review Article
C2 - 37639973
AN - SCOPUS:85169068391
SN - 1087-0792
VL - 71
JO - Sleep Medicine Reviews
JF - Sleep Medicine Reviews
M1 - 101838
ER -
