# Sleep apnea: what the research actually says

The most under-diagnosed sleep disorder there is: roughly 936 million adults have it and the large majority have never been told.



## All studies

- **Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis** — Benjafield AV, Ayas NT, Eastwood PR, et al. (2019), Lancet Respiratory Medicine 7(8):687–698. ~936 million adults aged 30–69 have OSA worldwide; ~425 million moderate-to-severe.

- **Increased prevalence of sleep-disordered breathing in adults** — Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM (2013), American Journal of Epidemiology 177(9):1006–1014. Prevalence in US adults 30–70: ~26% of men and ~9–17% of women; rising with obesity.

- **Defining phenotypic causes of obstructive sleep apnea. Identification of novel therapeutic targets** — Eckert DJ, White DP, Jordan AS, Malhotra A, Wellman A (2013), American Journal of Respiratory and Critical Care Medicine 188(8):996–1004. OSA has anatomical and non-anatomical phenotypes (muscle responsiveness, arousal threshold, loop gain) — the basis of precision treatment.

- **Relationship between overnight rostral fluid shift and obstructive sleep apnea in nonobese men** — Redolfi S, Yumino D, Ruttanaumpawan P, et al. (2009), American Journal of Respiratory and Critical Care Medicine 179(3):241–246. Fluid moving from the legs to the neck when lying down narrows the airway — apnea without obesity (Galpin's tipped-glass analogy).

- **STOP questionnaire: a tool to screen patients for obstructive sleep apnea** — Chung F, Yegneswaran B, Liao P, et al. (2008), Anesthesiology 108(5):812–821. Origin of the STOP-Bang screen; ≥3 'yes' answers = high sensitivity for moderate-severe OSA.

- **Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study** — Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005), Lancet 365(9464):1046–1053. Untreated severe OSA tripled fatal and non-fatal cardiovascular events over ~10 years; CPAP normalised the risk.

- **Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women** — Young T, Evans L, Finn L, Palta M (1997), Sleep 20(9):705–706. ~82% of men and ~93% of women with moderate-to-severe apnea were undiagnosed — the numbers Galpin quotes.

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Educational summary of published research, not medical advice. Screening scores are not diagnoses. If a score is elevated or you feel unwell, talk to a clinician.

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