Longitudinal risk factors for obstructive sleep apnea: A systematic review

Yaoyao Qian; Shyamali C Dharmage; Garun S Hamilton; Caroline J Lodge; Adrian J Lowe; Jingwen Zhang; Gayan Bowatte; Jennifer L Perret; Chamara V Senaratna

doi:10.1016/j.smrv.2023.101838

Longitudinal risk factors for obstructive sleep apnea: A systematic review

Sleep Med Rev. 2023 Oct:71:101838. doi: 10.1016/j.smrv.2023.101838. Epub 2023 Aug 19.

Authors

Yaoyao Qian¹, Shyamali C Dharmage¹, Garun S Hamilton², Caroline J Lodge¹, Adrian J Lowe³, Jingwen Zhang¹, Gayan Bowatte¹, Jennifer L Perret⁴, Chamara V Senaratna¹

Affiliations

¹ Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, Victoria, 3053, Australia.
² Monash Lung, Sleep, Allergy and Immunology, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia; School of Clinical Sciences, Monash University, 246 Clayton Road, Clayton, VIC, Australia. Electronic address: garun.hamilton@monashhealth.org.
³ Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, Victoria, 3053, Australia; Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC, 3052, Melbourne, Australia.
⁴ Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, Victoria, 3053, Australia; The Institute for Breathing and Sleep (IBAS) Melbourne, 145 Studley Rd, Heidelberg, VIC, 3084, Australia.

PMID: 37639973
DOI: 10.1016/j.smrv.2023.101838

Abstract

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.

Keywords: Cohort; General population; Longitudinal studies; Obstructive sleep apnea; Risk factors; Systematic review.

Publication types

Review