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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
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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

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Footnotes

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

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