Around one in five people may have obstructive sleep apnea (OSA), but most don’t realize their symptoms are signs of a problem. According to a study published in ERJ Open Research, only a small proportion of those affected have been diagnosed and are receiving treatment.

The study included data on 20,151 French adults. Researchers recorded how many participants had been diagnosed with OSA. They also used a questionnaire to gauge how many participants might have undiagnosed OSA. The questionnaire focuses on heavy snoring and excessive daytime sleepiness (the two most common OSA symptoms), high blood pressure, and obesity.

Researchers then used this data to calculate the proportion of the French population who are likely to be affected by OSA. They found that around one in five (20.2%) were highly likely to have OSA while only 3.5% were being treated for the condition.

OSA was more common in men, in people who were older, had cardiovascular disease, lower socioeconomic status, were less physically active, were smokers, and in people with symptoms of depression. Women were at a higher risk of going undiagnosed with OSA.

The study was led by Pauline Balagny, MD, from the faculty of medicine at the University of Paris-Cité, France. “We know that OSA is a major health hazard, but if patients are diagnosed with the condition, they can be given treatments and advice to mitigate the risks,” says Balagny in a release. “Our study suggests that OSA is common, but the majority of those affected do not know they have the condition. Our findings are in line with research in other countries which suggest that OSA is becoming more common.”

A key strength of this research is that it is based on a large group of people who are representative of the French population. A weakness is that the study relies on a questionnaire to gauge the likelihood of OSA, rather than testing participants in a sleep clinic.

Winfried Randerath, MD, head of the European Respiratory Society’s assembly on sleep-disordered breathing, who was not involved in the research, says in a release, “This research suggests that many people with OSA are not aware that their snoring and sleepiness are signs of a problem. We need to raise awareness of OSA because once people are diagnosed, they can be given treatment and advice to help lower their risk of other serious conditions such as stroke, heart disease, and diabetes. Although OSA is more common in men, this study indicates that we also need to get better at spotting the condition in women.”

Balagny and her colleagues will continue to study the links between OSA symptoms and cardiovascular diseases. They are also investigating whether screening for OSA could help heart attack patients.

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