如果以睡眠呼吸暂停低通气指数 (apnoea-hypopnoea index, AHI)≥5次/小时同时合并白天过度嗜睡作为诊断标准,推测美国有4%的男性和2%的女性患有OSA。[2]Young T, Palta M, Dempsey J, et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230-1235.http://www.nejm.org/doi/full/10.1056/NEJM199304293281704#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/8464434?tool=bestpractice.com然而,最近的估计值显示,男性的患病率高达 14%,女性的高达 5%。[3]Peppard PE, Young T, Barnet JH, et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177:1006-1014.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3639722/http://www.ncbi.nlm.nih.gov/pubmed/23589584?tool=bestpractice.com韩国男性和女性OSA的患病率大约分别为4.5%和3.2%,中国分别为4.1%和2.1%。 印度男性OSA患病率为7.5%,但奇怪的是该国肥胖发病率低。[4]Kim J, In K, Kim J, et al. Prevalence of sleep-disordered breathing in middle-aged Korean men and women. Am J Respir Crit Care Med. 2004;170:1108-1113.http://www.atsjournals.org/doi/full/10.1164/rccm.200404-519OC#.UtQGWdJdUREhttp://www.ncbi.nlm.nih.gov/pubmed/15347562?tool=bestpractice.com[5]Ip MS, Lam B, Lauder IJ, et al. A community study of sleep-disordered breathing in middle-aged Chinese men in Hong Kong. Chest. 2001;119:62-69.http://www.ncbi.nlm.nih.gov/pubmed/11157585?tool=bestpractice.com[6]Ip MS, Lam B, Tang LC, et al. A community study of sleep-disordered breathing in middle-aged Chinese women in Hong Kong: prevalence and gender differences. Chest. 2004;125:127-134.http://www.ncbi.nlm.nih.gov/pubmed/14718431?tool=bestpractice.com[7]Udwadia ZF, Doshi AV, Lonkar SG, et al. Prevalence of sleep-disordered breathing and sleep apnea in middle-aged urban Indian men. Am J Respir Crit Care Med. 2004;169:168-173.http://www.atsjournals.org/doi/full/10.1164/rccm.200302-265OC#.UtPHtNJdUREhttp://www.ncbi.nlm.nih.gov/pubmed/14604837?tool=bestpractice.com欧洲的结果类似,英国50岁左右的成人男性患病率为4%、女性为2%,西班牙男性为3%~3.4%、女性为1.7%-3%。[8]National Institute for Health and Care Excellence. Continuous positive airway pressure for the treatment of obstructive sleep apnoea/hypopnoea syndrome. March 2008. Available at http://guidance.nice.org.uk/ (last accessed 13 April 2017).http://guidance.nice.org.uk/TA139[9]Marin JM, Gascon JM, Carrizo S, et al. Prevalence of sleep-apnoea syndrome in the Spanish adult population. Int J Epidemiol. 1997;26:381-386.http://ije.oxfordjournals.org/cgi/reprint/26/2/381http://www.ncbi.nlm.nih.gov/pubmed/9169174?tool=bestpractice.com[10]Duran J, Esnaola S, Rubio R, et al. Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med. 2001;163:685-689.http://www.atsjournals.org/doi/full/10.1164/ajrccm.163.3.2005065#.UtPMadJdUREhttp://www.ncbi.nlm.nih.gov/pubmed/11254524?tool=bestpractice.com塞维利亚(西班牙城市)对101名青少年进行调查,以AHI≥10次/小时和过度嗜睡作为诊断标准,发现患病率为1.98%,无性别差异。[11]Sanchez-Armengol A, Fuentes-Pradera MA, Capote-Gil F, et al. Sleep-related breathing disorders in adolescents aged 12 to 16 years: clinical and polygraphic findings. Chest. 2001;119:1393-1400.http://www.ncbi.nlm.nih.gov/pubmed/11348944?tool=bestpractice.comOSA在美国西班牙裔,以及黑人和亚裔中患病率可能更多一些。[12]Kripke DF, Ancoli-Israel S, Klauber MR, et al. Prevalence of sleep-disordered breathing in ages 40-64 years: a population-based survey. Sleep. 1997;20:65-76.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2758699http://www.ncbi.nlm.nih.gov/pubmed/9130337?tool=bestpractice.com
OSA发病率随着年龄增长而增加。女性年龄每增加10岁,患OSA的几率就增大数倍。[13]Young T, Peppard PE, Taheri S. Excess weight and sleep-disordered breathing. J Appl Physiol. 2005;99:1592-1599.http://www.ncbi.nlm.nih.gov/pubmed/16160020?tool=bestpractice.com[14]Tishler PV, Larkin EK, Schluchter MD, et al. Incidence of sleep-disordered breathing in an urban adult population: the relative importance of risk factors in the development of sleep-disordered breathing. JAMA. 2003;289:2230-2237.http://jama.ama-assn.org/cgi/content/full/289/17/2230http://www.ncbi.nlm.nih.gov/pubmed/12734134?tool=bestpractice.com在威斯康辛睡眠队列研究中,30-60岁男性OSA患病率(AHI≥15次/小时)为9.1%,女性为4.0%。[2]Young T, Palta M, Dempsey J, et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230-1235.http://www.nejm.org/doi/full/10.1056/NEJM199304293281704#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/8464434?tool=bestpractice.com另一些研究发现,到50岁时,男女发病率相似,50岁后女性发病率可能更高。[14]Tishler PV, Larkin EK, Schluchter MD, et al. Incidence of sleep-disordered breathing in an urban adult population: the relative importance of risk factors in the development of sleep-disordered breathing. JAMA. 2003;289:2230-2237.http://jama.ama-assn.org/cgi/content/full/289/17/2230http://www.ncbi.nlm.nih.gov/pubmed/12734134?tool=bestpractice.com