Abstract

Abstract Introduction CPAP has been shown to be beneficial in symptomatic mild OSA. While many healthcare systems have appropriate pathways for treatment of moderate-severe OSA, there remain questions on how to manage treatment optimally for the mild OSA population. Females with OSA tend to be milder than their male counterparts, with lower AHIs, less oxygen desaturations, and different symptoms such as fatigue and insomnia. Females with mild OSA are at risk of being underdiagnosed and under treated. We explored global prevalence data to understand better the scope of this issue. Methods A recent publication contained estimations of the global prevalence and burden of OSA. This prevalence was calculated using sex and aged matched data from published prevalence studies, along with estimates for countries without prevalence data, a process which was done by matching the country to a similar country with prevalence data based on BMI, race, and geographical proximity. Finally, a newly developed conversion algorithm was used to standardize different scoring methodologies and to provide equivalent AHI. Raw data from this global prevalence exploration have been divided by sex, and then categorized based on the World Bank 2022 country income rankings, in order to estimate the prevalence of mild OSA in women. Results Data from adults aged 30-70 from 164 countries were included in this analysis. Data from 29 low-income countries were excluded due to insufficient information. Based on AASM 2012 scoring, it is estimated that globally at least 202,157,057 of 1,513,628,587 (13.4%) females have mild OSA. The prevalence of mild OSA was 14.6, 15.3, and 10.6% in females; compared to 23.5, 18.3, and 16.3% in males; in high income, upper-middle income, and lower-middle income countries, respectively. The prevalence of moderate-severe OSA was 9.9, 8.5, and 9.4% in females; compared to 22.2, 18.8, and 13.6% in males; in high income, upper-middle income, and lower-middle income countries, respectively. Conclusion Globally, mild OSA affects at least 202 million females (13.4%). The highest global OSA prevalence of 15.3% was seen in upper-middle income countries. Continuing awareness, education and appropriate treatment pathways are crucial to ensure this important group are not overlooked. Support (if any) This analysis was funded by ResMed.

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