Hostname: page-component-745bb68f8f-s22k5 Total loading time: 0 Render date: 2025-01-14T17:16:16.713Z Has data issue: false hasContentIssue false
  • English
  • Français

Should mild obstructive sleep apnoea be treated? A systematic review from the standpoint of disease progression

Published online by Cambridge University Press:  16 November 2022

P Y Fong Open the ORCID record for P Y Fong [Opens in a new window] ,
Z Y Tay ,
R Y Soh ,
S M C Fook ,
H H Li  and
C Q Phua
P Y Fong*
Affiliation:
Department of Otolaryngology, Sengkang General Hospital, Singapore
Z Y Tay
Affiliation:
Department of Otolaryngology, Sengkang General Hospital, Singapore
R Y Soh
Affiliation:
Sleep Medicine Unit, Sengkang General Hospital, Singapore
S M C Fook
Affiliation:
Health Science Research Unit, Singapore General Hospital, Singapore
H H Li
Affiliation:
Health Science Research Unit, Singapore General Hospital, Singapore
C Q Phua
Affiliation:
Department of Otolaryngology, Sengkang General Hospital, Singapore Sleep Medicine Unit, Sengkang General Hospital, Singapore
*
Corresponding author: Mr P Y Fong, Department of Otolaryngology, Sengkang General Hospital, 110 Sengkang E Way, Singapore 544886, Singapore E-mail: peiyuan.fong@mohh.com.sg
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

This study was a systematic review to investigate the progression of untreated obstructive sleep apnoea in order to evaluate whether mild obstructive sleep apnoea should be treated from the standpoint of disease progression.

Method

The database search study outcomes that were collected included Apnea Hypopnea Index and Respiratory Disturbance Index. A meta-analysis of obstructive sleep apnoea severity over time intervals was performed.

Results

A total of 17 longitudinal studies and 1 randomised, controlled trial were included for review. For patients with mild obstructive sleep apnoea, mean pre-study and post-study Apnea Hypopnea Index was 5.21 and 8.03, respectively, over a median interval of 53.1 months. In patients with moderate to severe obstructive sleep apnoea, mean pre-study and post-study Apnea Hypopnea Index was 28.9 and 30.3, respectively, over a median interval of 57.8 months. Predictors for disease progression in mild obstructive sleep apnoea are patients aged less than 60 years and those with a baseline body mass index less than 25.

Conclusion

Mild obstructive sleep apnoea progression is observed, but it does not appear to reach any clinically significant progression to moderate or severe obstructive sleep apnoea.

Keywords

Sleep Apnea, ObstructiveSleep Disordered BreathingBody Mass IndexSnoring
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 8 , August 2023 , pp. 828 - 839
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mr P Y Fong takes responsibility for the integrity of the content of the paper

References

Lévy, P, Kohler, M, McNicholas, WT et al. Obstructive sleep apnoea syndrome. Nat Rev Dis Primers 2015;1;15015CrossRefGoogle ScholarPubMed
Fu, Y, Xia, Y, Yi, H, Xu, H, Guan, J, Yin, S. Meta-analysis of all-cause and cardiovascular mortality in obstructive sleep apnea with or without continuous positive airway pressure treatment. Sleep Breath 2017;21:181–9CrossRefGoogle ScholarPubMed
Baldwin, CM, Griffith, KA, Nieto, FJ, O'Connor, GT, Walsleben, JA, Redline, S. The association of sleep-disordered breathing and sleep symptoms with quality of life in the sleep heart health study. Sleep 2001;24:96–105CrossRefGoogle ScholarPubMed
Yosunkaya, S, Kutlu, R, Cihan, FG. Evaluation of depression and quality of life in patients with obstructive sleep apnea syndrome. Niger J Clin Pract 2016;19:573–9CrossRefGoogle ScholarPubMed
Kushida, CA, Littner, MR, Hirshkowitz, M, Morgenthaler, TI, Alessi, CA, Bailey, D et al. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep 2006;29:375–80CrossRefGoogle ScholarPubMed
Gay, P, Weaver, T, Loube, D, Iber, C, Positive Airway Pressure Task Force, Standards of Practice Committee et al. Evaluation of positive airway pressure treatment for sleep related breathing disorders in adults. Sleep 2016;298:381–401Google Scholar
Marshall, NS. Continuous positive airway pressure reduces daytime sleepiness in mild to moderate obstructive sleep apnoea: a meta-analysis. Thorax 2006;61:430–4CrossRefGoogle ScholarPubMed
Sahlman, J, Pukkila, M, Seppä, J, Tuomilehto, H. Evolution of mild obstructive sleep apnea after different treatments. Laryngoscope 2007;11:1107–11CrossRefGoogle Scholar
Redline, S, Adams, N, Strauss, ME, Roebuck, T, Winters, M, Rosenberg, C et al. Improvement of mild sleep-disordered breathing with CPAP compared with conservative therapy. Am J Respir Crit Care Med 1998;157:858–65CrossRefGoogle ScholarPubMed
Jokic, R, Klimaszewski, A, Crossley, M, Sridhar, G, Fitzpatrick, MF. Positional treatment vs continuous positive airway pressure in patients with positional obstructive sleep apnea syndrome. Chest 1999;115;771–81CrossRefGoogle ScholarPubMed
Barnes, M, McEvoy, RD, Banks, S, Tarquinio, N, Murray, CG, Vowles, N et al. Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. Am J Respir Crit Care Med 2004;170:656–64CrossRefGoogle ScholarPubMed
Chong, MS, Ayalon, L, Marler, M, Loredo, JS, Corey-Bloom, J, Palmer, BW et al. Continuous positive airway pressure reduces subjective daytime sleepiness in patients with mild to moderate Alzheimer's disease with sleep disordered breathing. J Am Geriatr Soc 2006;54:777–81CrossRefGoogle ScholarPubMed
Becker, HF, Jerrentrup, A, Ploch, T, Grote, L, Penzel, T, Sullivan, CE et al. Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation 2003;107:68–73CrossRefGoogle ScholarPubMed
Chakravorty, I, Cayton, RM., Szczepura, A. Health utilities in evaluating intervention in the sleep apnoea/hypopnoea syndrome. Eur Respir J 2002;20:1233–8CrossRefGoogle ScholarPubMed
Bardwell, WA, Ancoli-Israel, S, Berry, CC et al. Neuropsychological effects of one-week continuous positive airway pressure treatment in patients with obstructive sleep apnea: a placebo-controlled study. Psychosomatic Med 2001;63:579–84CrossRefGoogle ScholarPubMed
Loredo, JS, Ancoli-Israel, S, Dimsdale, JE. Effect of continuous positive airway pressure vs placebo continuous positive airway pressure on sleep quality in obstructive sleep apnea. Chest 1999;116:1545–9CrossRefGoogle ScholarPubMed
Yu, BH, Ancoli-Israel, S, Dimsdale, JE. Effect of CPAP treatment on mood states in patients with sleep apnea J Psychiatric Res 1999 ; 33:427–32CrossRefGoogle ScholarPubMed
Lindberg, E, Elmasry, A, Gislason, T, Janson, C, Bengtsson, H, Hetta, J et al. Evolution of sleep apnea syndrome in sleepy snorers: a population-based prospective study. Am J Respir Crit Care Med 1999;159:2024–7CrossRefGoogle ScholarPubMed
Peppard, PE, Young, T, Palta, M, Dempsey, J, Skatrud, J. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA 2000;284:3015–21CrossRefGoogle ScholarPubMed
Young, T, Peppard, PE, Gottlieb, DJ. Epidemiology of obstructive sleep apnea a population health perspective. Am J Respir Crit Care Med 2002;165:1217–39CrossRefGoogle ScholarPubMed
Redline, S, Larkin, E, Schluchter, M, Redline, S. Incidence of sleep disordered breathing (SDB) in a population-based sample. Sleep 2001;24:511Google Scholar
Hoch, CC, Dew, MA, Reynolds, CF, Buysse, DJ, Nowell, PD, Monk, TH et al. Longitudinal changes in diary- and laboratory-based sleep measures in healthy “old old” and “young old” subjects: a three-year follow-up. Sleep 1997;20:192–202CrossRefGoogle ScholarPubMed
Pendlebury, ST, Pépin, JL, Veale, D, Levy, P. Natural evolution of moderate sleep apnoea syndrome: significant progression over a mean of 17 months. Thorax 1997;52:872–8CrossRefGoogle Scholar
Quan, SF. Evolution of OSA. Thorax 1998;53:532CrossRefGoogle ScholarPubMed
Hayashida, K, Kobayashi, M, Namba, K, Ueki, Y, Nakayama, H, Ito, E et al. Progression of obstructive sleep apnoea syndrome in Japanese patients. Sleep Breath 2016;20:711–8CrossRefGoogle ScholarPubMed
Sforza, E, Addati, G, Cirignotta, F, Lugaresi, E et al. Natural evolution of sleep apnoea syndrome: a five year longitudinal study. Eur Respir J 1994;7:1765–70CrossRefGoogle ScholarPubMed
Sforza, E, Gauthier, M, Crawford-Achour, E, Pichot, V, Maudoux, D, Barthlemy, JC et al. A 3-year longitudinal study of sleep disordered breathing in the elderly. Eur Respir J 2012;40:665–72CrossRefGoogle ScholarPubMed
Bliwise, D, Carskadon, M, Carey, E, Dement, W et al. Longitudinal development of sleep-related respiratory disturbance in adult humans. J Gerontol 1984;39:290–3CrossRefGoogle ScholarPubMed
Phoha, RL, Dickel, MJ, Mosko, SS. Preliminary longitudinal assessment of sleep in the elderly. Sleep 1990;13:425–9CrossRefGoogle ScholarPubMed
Redline, S, Schluchter, MD, Larkin, EK, Tishler, PV. Predictors of longitudinal change in sleep-disordered breathing in a nonclinic population. Sleep 2003;26:703–9CrossRefGoogle Scholar
Newman, AB, Foster, G, Givelber, R, Nieto, FJ, Redline, S, Young, T. Progression and regression of sleep-disordered breathing with changes in weight: the Sleep Heart Health Study. Arch Intern Med 2005;165:2408–13CrossRefGoogle ScholarPubMed
Ancoli-Israel, S, Kripke, DF, Klauber, MR, Parker, L, Stepnowsky, C, Kullen, A et al. Natural history of sleep disordered breathing in community dwelling elderly. Sleep 1993;16:S25–9CrossRefGoogle Scholar
Fisher, D, Pillar, G, Malhotra, A, Peled, N, Lavie, P et al. Long-term follow-up of untreated patients with sleep apnoea syndrome. Respir Med 2002;96:337–43CrossRefGoogle ScholarPubMed
Mason, WJ, Ancoli Israel, S, Kripke, DF. Apnoea revised: a longitudinal follow up. Sleep 1989;12:423–9CrossRefGoogle Scholar
Berger, G, Berger, R, Oksenberg, A. Progression of snoring and obstructive sleep apnoea: the role of increasing weight and time. Eur Respir J 2009;33:338–45CrossRefGoogle ScholarPubMed
Sasaki, T. Age-associated weight gain, leptin, and sirt1: a possible role for hypothalamic sirt1 in the prevention of weight gain and aging through modulation of leptin sensitivity. Front Endocrinol (Lausanne) 2015;6:109CrossRefGoogle ScholarPubMed
Montero, D, Breenfeldt-Andersen, A, Oberholzer, L, Haider, T. Effect of exercise on arterial stiffness: is there a ceiling effect? Am J Hypertens 2017;30:1069–72CrossRefGoogle Scholar
Lee, HH, Kim, DY, Sohn, MK, Shin, Y-I, Oh, G-J, Lee, Y-S et al. Revisiting the proportional recovery model in view of the ceiling effect of Fugl–Meyer assessment. Stroke 2021;52:3167–75CrossRefGoogle ScholarPubMed
Marotta, AM, Borel, J-C, Galerneau, LM, Tamisier, R, Bonsignore, MR, Pepin, JL. Cardiovascular events in moderately to severely obese obstructive sleep apnea patients on positive airway pressure therapy. Respir Int Rev Thoracic Dis 2017;93:179–88Google ScholarPubMed
Yang, EH, Hla, KM, McHorney, CA, Tavighurst, T, Badr, MS, Weber, S. Sleep apnea and quality life. Sleep 2000;23:535–41CrossRefGoogle Scholar
Gray, EL, McKenzie, DK, Eckert, DJ. Obstructive sleep apnea without obesity is common and difficult to treat: evidence for a distinct pathophysiological phenotype. J Clin Sleep Med 2017;13:81–8CrossRefGoogle ScholarPubMed
Supplementary material: File

Fong et al. supplementary material

Table S1 and Figure S1

Download Fong et al. supplementary material(File)
File 341.9 KB