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Review
. 2023 Dec;27(6):2083-2109.
doi: 10.1007/s11325-023-02810-7. Epub 2023 Mar 27.

Worldwide prevalence and associated risk factors of obstructive sleep apnea: a meta-analysis and meta-regression

Anna Beatriz de Araujo Dantas  1 , Flávio Magno Gonçalves  2   3 , Agnes Andrade Martins  1   3 , Giorvan Ânderson Alves  4 , José Stechman-Neto  2   3 , Camila de Castro Corrêa  3   5 , Rosane Sampaio Santos  2   3 , Weslania Viviane Nascimento  3   6 , Cristiano Miranda de Araujo  2   3 , Karinna Veríssimo Meira Taveira  7   8
Affiliations
Review

Worldwide prevalence and associated risk factors of obstructive sleep apnea: a meta-analysis and meta-regression

Anna Beatriz de Araujo Dantas et al. Sleep Breath. 2023 Dec.

Abstract

Purpose: This study aimed to identify the prevalence of obstructive sleep apnea (OSA) and associated risk factors globally.

Methods: Six databases and registrations and three grey databases were explored for observational field research. Independently and impartially paired reviewers selected research, gathered data, and evaluated the methodological quality. Heterogeneity was investigated using subgroup analysis and meta-regression following the moderating variable in a meta-analysis of proportions with a random-effects model. The critical appraisal instrument developed by the Joanna Briggs Institute was used to evaluate the listed studies' methodology. The certainty of the evidence was evaluated using the GRADE tool.

Results: A total of 8236 articles were collected during the database search, resulting in 99 articles included for qualitative synthesis, and 98 articles were included for the meta-analysis. The estimated combined prevalence of OSA was 54% [CI 95% = 46-62%; I2 = 100%]. Mean age, percentage of moderate-severe cases, and the sample's body mass index (BMI) did not affect the heterogeneity that was already present when meta-regressed (p > 0.05). Ninety-one studies were deemed to have a low risk of bias, while eight were deemed to have a moderate risk. For OSA prevalence outcomes, the GRADE criteria were considered very low.

Conclusion: Approximately half of the people worldwide have OSA. High BMI, increasing age, and male gender are described as risk factors in the literature, but these covariates do not affect pre-existing heterogeneity.

Keywords: Obstructive sleep apnea; Prevalence; Risk factors; Systematic review.

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