Evidence map›Paper›PMID 31300334›Full record

ReviewThe Lancet. Respiratory medicine2019

Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis.

Adam V Benjafield, Najib T Ayas, Peter R Eastwood, Raphael Heinzer, Mary S M Ip, Mary J Morrell, Carlos M Nunez, Sanjay R Patel, Thomas Penzel, Jean-Louis Pépin and 5 more

15 registry-linked trialsAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in The Lancet. Respiratory medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 15 registered trials, which are not on this map. Cited by 2,186 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2,186citing papers in PubMed, 13 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04399200 recruitingnot on this mapstarted 2020, after this paper: background citation

Sleep Apnea Syndrome and Incidence of Major Adverse Cardiac and Cerebrovascular Events (MACCEs) After a First Stroke

TypeobservationalSponsorUniversity Hospital, GrenobleRan2020 to 2035Enrolled1,620ConditionsStroke, Sleep-disordered Breathing, Sleep Apnea Syndromes, Sleep Apnea, ObstructiveArmsTreatment according to standard care recommandation
NCT04608331 phase4completednot on this mapstarted 2021, after this paper: background citation

Impact of Dexmedetomidine Supplemented Analgesia on Sleep Quality in Patients at High-risk of Obstructive Sleep Apnea After Major Surgery: A Randomized, Double-blind, and Placebo-controlled Pilot Study

TypeinterventionalSponsorPeking University First HospitalRan2021 to 2022Enrolled152ConditionsObstructive Sleep Apnea, Analgesia, Dexmedetomidine, High-flow Nasal CannulaArmsDexmedetomidine, Placebo
NCT05303935 phase2completednot on this mapstarted 2022, after this paper: background citation

Effects of Quetiapine on Sleep and Next Day Alertness in People With Obstructive Sleep Apnea

TypeinterventionalSponsorFlinders UniversityRan2022 to 2023Enrolled15ConditionsSleep Apnea, ObstructiveArmsQuetiapine 50 MG, Placebo
NCT05385302 unknown statusnot on this mapstarted 2022, after this paper: background citation

Sociological Determinants of Adherence to Continuous Positive Airway Pressure In the Management of Sleep Apnea Syndrome - A Transdisciplinary Approach.

TypeobservationalSponsorUniversity Hospital, GrenobleRan2022 to 2025Enrolled250ConditionsAdherence, Treatment, Health Literacy, Obstructive Sleep Apnea
NCT05390138 naunknown statusnot on this mapstarted 2022, after this paper: background citation

A Smart Sleep Apnea Self-management Support Programme(4S) to Improve Apnea Severity and Cardiovascular Health - A Pragmatic Randomized Controlled Trial With Mixed-method Evaluation

TypeinterventionalSponsorThe University of Hong KongRan2022 to 2024Enrolled120ConditionsObstructive Sleep ApneaArmsSmart Sleep Apnea Self-management Support Programme (4S), General Hygiene Information (GH)
NCT05549245 naunknown statusnot on this mapstarted 2022, after this paper: background citation

RCT Study of Short-term Clinical Efficacy of High Flow Nasal Catheter Oxygen Therapy for Obstructive Sleep Apnea

TypeinterventionalSponsorQilu Hospital of Shandong UniversityRan2022 to 2023Enrolled194ConditionsObstructive Sleep ApneaArmshigh-flow nasal cannula oxygen therapy,, CPAP
NCT05549310 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Long-term Effect of High Flow Nasal Canula Therapy on Obstructive Sleep Apnea

TypeinterventionalSponsorQilu Hospital of Shandong UniversityRan2022 to 2025Enrolled186ConditionsObstructive Sleep Apnea, High Flow Nasal Canula, Continuous Positive Airway Pressure VentilationArmsCPAP, high-flow nasal canula oxygen therapy
NCT06008678 nacompletednot on this mapstarted 2023, after this paper: background citation

A Multicenter, Single-Arm, Safety and Efficacy Study of the Resvent RXiBreeze™ PAP System to Treat Obstructive Sleep Apnea

TypeinterventionalSponsorResvent Holding USA LTDRan2023 to 2023Enrolled146ConditionsObstructive Sleep ApneaArmsRXiBreeze PAP System, Model RXiBreeze 20A
NCT06331819 recruitingnot on this mapstarted 2024, after this paper: background citation

Clinical Association Between Obstructive Sleep Apnea (OSA) and Facial Pigmentation, and the Relation Between OSA and Vasovagal Symptoms With Resulting Smoking Tendency and the Effect of Treatment in Patients Referred for Sleep Study.

TypeobservationalSponsorJordan Collaborating Cardiology GroupRan2024 to 2026Enrolled200ConditionsObstructive Sleep Apnea, Vasovagal Syncope, Smoking, Acanthosis NigricansArmsIn-lab polysomnography, Continuous positive airway pressure, Home sleep study device
NCT06566482 phase4recruitingnot on this mapstarted 2024, after this paper: background citation

Mini-dose Dexmedetomidine-Esketamine Supplemented Analgesia for Postoperative Sleep Promotion in Patients at High-risk of Obstructive Sleep Apnea: A Randomized Trial

TypeinterventionalSponsorPeking University First HospitalRan2024 to 2025Enrolled100ConditionsObstructive Sleep Apnea, Surgery, Dexmedetomidine, EsketamineArmsDexmedetomidine-esketamine combination, Placebo
NCT06928766 phase2not yet recruitingnot on this mapstarted 2025, after this paper: background citation

Effects of Eszopiclone and Lemborexant in People With Obstructive Sleep Apnoea (OSA) With a Low Arousal Threshold Who Have Difficulty Maintaining or Falling Asleep (ELOSA): A Double-blind, Placebo-controlled, Randomised, Trial.

TypeinterventionalSponsorFlinders UniversityRan2025 to 2027Enrolled15ConditionsOSA - Obstructive Sleep ApneaArmsEszopiclone 3 mg, Placebo, Lemborexant 10mg
NCT07087587 narecruitingnot on this mapstarted 2025, after this paper: background citation

Sleep Apnea Triggers of Atrial Fibrillation: N-of-1 Randomized Control Trial (SPARTA):

TypeinterventionalSponsorThe Cleveland ClinicRan2025 to 2026Enrolled20ConditionsAfib, Sleep Apnea Syndrome, Obstructive, CPAPArmsCPAP
NCT07432919 not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Evaluation of the Diagnostic Capacity of a Smart Mattress Versus Conventional Polysomnography

Typeobservational_patient_registrySponsorHospital San Pedro de LogroñoRan2026 to 2028Enrolled500ConditionsObstructive Sleep Apnea (OSA)ArmsIntegrated polysomnographic assessment with smart mattress.
NCT07530302 narecruitingnot on this mapstarted 2026, after this paper: background citation

Treatment Failure of Continuous Positive Airway Pressure (CPAP) in Patients With Obstructive Sleep Apnea Syndrome (OSA): A Randomized Controlled Trial Comparing Polysomnography and the Sunrise Device to Drive Treatment-Adjustment Decisions.

TypeinterventionalSponsorUniversity Hospital, GrenobleRan2026 to 2029Enrolled105ConditionsSleep Apnea Syndrome, ObstructiveArmsSunrise
NCT07723144 narecruitingnot on this mapstarted 2025, after this paper: background citation

Identification of Biomarkers to Understand the Pathogenesis of Obstructive Sleep Apnea.

TypeinterventionalSponsorMedical University of BialystokRan2025 to 2029Enrolled120ConditionsObstructive Sleep Apnea, Obstructive Sleep Apnea (OSA), Obstructive Sleep Apnea (OSAS), Obstructive Sleep Apnea (SAOS)ArmsPositive Airway Pressure (PAP) Therapy
3 · Its place in the literature

Who cites it

2,186 citing papers in PubMed, 13 syntheses or guidelines pooled it.

  1. Pooled it
  2. Oral appliances for obstructive sleep apnoea in adults.The Cochrane database of systematic reviews · 2026
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  12. Racial and Ethnic Disparities in the Diagnosis and Treatment of Obstructive Sleep Apnea: A Systematic Review.International journal of environmental research and public health · 2026
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2,126 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Adam V BenjafieldResMed Science Center, San Diego, CA, USA.
Najib T AyasDepartment of Medicine, University of British Columbia, Vancouver, BC, Canada.
Peter R EastwoodCentre for Sleep Science, School of Human Sciences, University of Western Australia, and Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, Perth, WA, Australia.
Raphael HeinzerCenter for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne, Lausanne, Switzerland.
Mary S M IpDepartment of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China.
Mary J MorrellNational Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield NHS Foundation Trust, London, UK.
Carlos M NunezResMed Science Center, San Diego, CA, USA.
Sanjay R PatelDivision of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Thomas PenzelCharité - Universitätsmedizin Berlin, Berlin, Germany.
Jean-Louis PépinHP2 Laboratory, INSERM U1042, Univ. Grenoble Alpes, and EFCR laboratory, Grenoble Alpes University Hospital, Grenoble, France.
Paul E PeppardDepartment of Population Health Sciences, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA.
Sanjeev SinhaAll India Institute of Medical Sciences, New Delhi, India.
Sergio TufikUniversidade Federal de Sao Paulo, Sao Paulo, Brazil.
Kate ValentineResMed Science Center, San Diego, CA, USA.
Atul MalhotraUniversity of California San Diego, La Jolla, CA, USA. Electronic address: amalhotra@ucsd.edu.

Funding

Single Motor Unit Genioglossus Recordings to Understand Sleep Apnea PathogenesisR01HL085188 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2008 to 2018
$3.5M
Training in the Next Generation in Respiratory ScienceT32HL134632 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL, POWELL, FRANK L. · 2017 to 2021
$2.1M
Assessment of Upper Airway Mechanics Using Newer Electromyographic TechniquesK24HL132105 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2016 to 2020
$611k
NHLBI NIH HHS K24 HL132105NHLBI NIH HHS R01 HL085188NHLBI NIH HHS T32 HL134632
6 · The paper itself

Abstract

backgroundThere is a scarcity of published data on the global prevalence of obstructive sleep apnoea, a disorder associated with major neurocognitive and cardiovascular sequelae. We used publicly available data and contacted key opinion leaders to estimate the global prevalence of obstructive sleep apnoea.

methodsWe searched PubMed and Embase to identify published studies reporting the prevalence of obstructive sleep apnoea based on objective testing methods. A conversion algorithm was created for studies that did not use the American Academy of Sleep Medicine (AASM) 2012 scoring criteria to identify obstructive sleep apnoea, allowing determination of an equivalent apnoea-hypopnoea index (AHI) for publications that used different criteria. The presence of symptoms was not specifically analysed because of scarce information about symptoms in the reference studies and population data. Prevalence estimates for obstructive sleep apnoea across studies using different diagnostic criteria were standardised with a newly developed algorithm. Countries without obstructive sleep apnoea prevalence data were matched to a similar country with available prevalence data; population similarity was based on the population body-mass index, race, and geographical proximity. The primary outcome was prevalence of obstructive sleep apnoea based on AASM 2012 diagnostic criteria in individuals aged 30-69 years (as this age group generally had available data in the published studies and related to information from the UN for all countries).

findingsReliable prevalence data for obstructive sleep apnoea were available for 16 countries, from 17 studies. Using AASM 2012 diagnostic criteria and AHI threshold values of five or more events per h and 15 or more events per h, we estimated that 936 million (95% CI 903-970) adults aged 30-69 years (men and women) have mild to severe obstructive sleep apnoea and 425 million (399-450) adults aged 30-69 years have moderate to severe obstructive sleep apnoea globally. The number of affected individuals was highest in China, followed by the USA, Brazil, and India.

interpretationTo our knowledge, this is the first study to report global prevalence of obstructive sleep apnoea; with almost 1 billion people affected, and with prevalence exceeding 50% in some countries, effective diagnostic and treatment strategies are needed to minimise the negative health impacts and to maximise cost-effectiveness.

fundingResMed.

Indexed as

Cost of IllnessAdultAgedAsiaAustralasiaEuropeFemaleHumansInternationalityMaleMiddle AgedPrevalenceSleep Apnea, ObstructiveSouth AmericaUnited States

Identifiers

PMID31300334
PMCPMC7007763

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.