Sleep apnoea syndrome and sleep-disordered breathing (SDB) are becoming more recognized as widespread and serious health issues, especially with the rise in obesity and an aging population.
These conditions, particularly obstructive sleep apnoea (OSA), cause breathing interruptions during sleep, leading to poor sleep quality and various health risks.
As awareness grows, understanding the prevalence and contributing factors is essential to addressing the growing burden on individuals and healthcare systems.
This article explores the commonality of sleep apnoea and SDB and the factors driving their increasing prevalence, particularly among adults.
What is the Prevalence of Sleep Apnoea Syndrome?
Sleep apnoea syndrome, particularly obstructive sleep apnoea (OSA), is a common form of sleep-disordered breathing where the airway becomes temporarily blocked during sleep, causing disrupted breathing and fragmented sleep.
OSA affects approximately 2-4% of men and 1-2% of women, with prevalence increasing in those over 40.
However, many cases go undiagnosed, and some estimates suggest up to 25% of adults experience sleep apnoea to varying degrees. Central sleep apnoea (CSA), less common than OSA, occurs when the brain fails to send proper breathing signals.
Sleep apnoea is linked to serious health issues like hypertension, heart disease, stroke, and type 2 diabetes, underlining the importance of early diagnosis and treatment.
How Common is Sleep-Disordered Breathing?
Sleep-disordered breathing (SDB) encompasses various breathing abnormalities during sleep, including snoring, central apnoea, and obstructive apnoea (OSA). While snoring is often benign, it can signal more serious forms of SDB.
The global prevalence of SDB is high, with estimates suggesting that up to 40% of adults experience some form, ranging from mild to severe. Mild SDB may not require medical treatment but still leads to sleep disruption and daytime fatigue.
Prevalence varies by age, gender, and lifestyle, with men being more affected, though the gap closes post-menopause. Obesity is a significant risk factor for SDB, particularly OSA, along with smoking, alcohol use, family history, and certain anatomical features like large neck circumference or enlarged tonsils.
Has the Prevalence of Sleep-Disordered Breathing in Adults Increased?
In recent decades, the prevalence of sleep disordered breathing particularly in adults, has risen significantly. Several factors contribute to this increase, including lifestyle changes, shifts in diet and activity levels, and the aging population.
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Obesity Epidemic: The global rise in obesity, with over 650 million obese adults worldwide, is a major contributor to the increased prevalence of sleep apnoea. Obesity causes excess fatty tissue in the upper airway, increasing the risk of airway obstruction during sleep, with most people suffering from moderate to severe OSA being overweight or obese.
- Aging Population: As the population ages, particularly those over 60, muscle tone in the airway decreases, making older adults more vulnerable to sleep apnoea. Aging, combined with factors like obesity or family history, significantly increases the risk of OSA, with more than 50% of men aged 60 and older potentially experiencing sleep-disordered breathing.
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Increased Awareness and Diagnosis: Improved diagnostic tools and greater awareness of sleep-disordered breathing have led to more diagnoses and treatments. Previously underdiagnosed, sleep apnoea is now recognized more frequently, with more individuals seeking medical help, which has led to higher reported cases.
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Environmental Factors: Environmental issues like air pollution and allergens can worsen sleep apnoea by causing inflammation in the upper airways. Additionally, lifestyle factors like stress, long working hours, and poor sleep habits may exacerbate the condition and affect sleep quality.
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Technological Advances in Treatment: Technological advancements, such as home sleep testing and CPAP machines, have made diagnosing and treating sleep apnoea more accessible. Portable monitoring devices and mobile apps that track sleep patterns have helped raise awareness, leading to more individuals seeking treatment.
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Changing Bed Sheets: Regularly changing bed sheets can help reduce allergens such as dust mites and pet dander, which can irritate the airways and worsen sleep apnoea symptoms. Clean sheets contribute to a healthier sleep environment, potentially improving overall sleep quality and reducing inflammation in the upper airways.
What is the prevalence of OSA by BMI?
The prevalence of obstructive sleep apnoea (OSA) is closely linked to body mass index (BMI). Studies have shown that individuals with higher BMI are at a significantly increased risk of developing OSA. Here’s a breakdown based on BMI:
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Normal weight : The prevalence of OSA is relatively low, but still present, especially among individuals with other risk factors.
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Overweight : The risk of OSA begins to rise, and approximately 20-30% of overweight individuals may have some form of sleep apnoea.
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Obese : Obesity is the most significant risk factor for OSA, with prevalence rates reaching up to 60-90% of obese individuals. As BMI increases, the severity of OSA also tends to increase, particularly in those with morbid obesity (BMI 40+).
In general, obesity contributes to fatty tissue accumulation around the airway, leading to an increased risk of airway obstruction during sleep. Therefore, maintaining a healthy weight is one of the most effective preventive measures for OSA.
Conclusion
The rising prevalence of sleep apnoea and sleep-disordered breathing presents a growing public health challenge. Factors such as obesity, aging populations, and increased awareness have contributed to the increasing recognition of these conditions.
While sleep apnoea can lead to serious health issues, early diagnosis and treatment, including advancements in diagnostic tools and therapies like CPAP, offer hope for improving quality of life and reducing health risks.
With continued awareness, timely intervention, and lifestyle changes, the impact of sleep apnoea and sleep-disordered breathing can be significantly mitigated, leading to better health outcomes for individuals and society alike.
