Sleep Apnea Rates Are Even Higher Than Suspected
According to research presented at the 2019 SLEEP conference in San Antonio, Texas, sleep apnea rates are even higher than previously suspected, with estimates reaching 1 billion for obstructive sleep apnea worldwide, and as many as 38 percent of adults in North, Central, and South America. The conference, organized by the Associated Professional Sleep Societies, is a joint venture of the American Academy of Sleep Medicine (AASM) and the Sleep Research Society, two of the largest groups in the world currently supporting sleep research. Before this study, the prevalence of OSA had not been thoroughly assessed, and this breakthrough research may help to attract further revenue streams in the direction of sleep apnea research in the years to come. While sleep professionals have known that OSA rates in particular were high in many countries, a global analysis gives them a complete view of the problem on a much larger scale, affirming estimates that rates are even higher than previously assumed.
In an interview with Reuters Health, the head researcher of the study, Dr. Adam Benjafield of ResMed, referred to obesity as the number-one driver of OSA in the West, and possibly the rest of the world as well. The rise in obesity rates, along with changes in scoring rules by the American Academy of Sleep Medicine (AASM), have contributed to further inclusions in larger counts. As a result of the scoring changes, the qualifications for sleep apnea have become slightly less strict, recognizing more individuals with moderate cases of the disorder. In countries with less data on medical records, these qualifications have made a major difference, as over 100 countries were included in estimates, according to reports by ResMed. This amounted to ten times the World Health Organization’s 2007 estimate of more than 100 million individuals with sleep apnea, further emphasizing the need for more research, long-term clinical studies, broad public-awareness campaigns across national borders, and better diagnostic tools to properly assess and treat a global population of sufferers, many of whom do not have have access to proper medical care or equipment.
Using data from the World Health Organization, the United Nations World Population Prospects, and medical reports by region, the results of the large-scale literature review were originally presented at the ATS 2018 International Conference in San Diego, but the findings at the time were preliminaries. Once the conclusive data and analysis was presented at the 2019 Sleep conference, audiences reacted with an enthusiastic call for improved screenings throughout the world. According to the data, more than 85 percent of sleep apnea patients are still undiagnosed, and
The data covered multiple countries in a review of literature throughout the the end of the 20th and beginning of the 21st century, using AASM diagnostic criteria for OSA and AHI threshold value, resulting in a specific total of 936 million adults aged 30–69 years and 425 million adults aged 30–69 years. The number of affected individuals was highest in China, where nearly 50 percent of the population were potentially affected. The U.S. came in second in total rates, followed by Brazil, Colombia, and India. Looking back at estimates as recent as 2013, it is clear that numbers for North America have increased over 4 percent in less than a decade. And for the 40 or more countries of the Americas, the team estimates that 170 million adults in total may suffer from OSA, 81 million of which reside within the western hemisphere. A review of this size and scope took years to conduct using a team of researchers looking at the results of sleep studies around the world and with large representative groups of each population. While the completion of the study is a milestone for sleep research and analysis, researchers continue to look into the prevalence of sleep-disordered breathing, the role of obesity, and treatment implications for patients throughout the world.
Unfortunately, while large-scale reviews like this can help provide the medical community with vital information about diseases and disorders, the task of implementing a strategy to reach potential sufferers for proper diagnosis and treatment is often costly and challenging, especially on a global scale. The review’s senior author, Dr. Benjafield of ResMed, the vice president of medical affairs, reported to ResMed that more than 85 percent of sleep apnea patients remain undiagnosed, despite overwhelming evidence that the disorder is highly prevalent throughout the world. This means that hundreds of millions of individuals routinely suffer needlessly and lack the sleep their bodies need for healthy living, day after day. In addition, the rate of comorbid conditions such as hypertension, stroke, coronary artery disease, heart failure, and cardiovascular mortality are likely on the rise as well, making individuals less healthy while increasing the likelihood of accidents due to daytime sleepiness and fatigue.
While undiagnosed sleep apnea is clearly a public health concern, it is also part of a larger picture of access to adequate healthcare and high-cost premiums, which is a major problem in the U.S., where rates are highest. While the data will help healthcare providers and sleep specialists advocate for programs and public education campaigns, access to gold-standard treatments, such as the highest quality CPAP or BiPAP machines, may remain difficult for many, regardless of their country of origin. While providers and educators can focus more on prevention as well, especially in regard to obesity, the research highlights an immediate need for treatment, for technological progress, and for broadened us of diagnostic measures. The challenge, despite these findings, will be for an entire shift in the global response to an epidemic of sleep-disordered breathing.
AASM.org – https://aasm.org/
American Journal of Epidemiology – https://www.ncbi.nlm.nih.gov/pubmed/23589584
Healthcare – The Global Problem of Insufficient Sleep and Its Serious Public Health Implications (recent)
ResMed – https://investors.resmed.com/investor-relations/events-and-presentations/press-releases/press-release-details/2019/The-Lancet-Publishes-More-Than-936-Million-Have-Obstructive-Sleep-Apnea-Worldwide/default.aspx
United Nations World Population Prospects – https://population.un.org/wpp/
World Health Organization – https://www.who.int/