The prevalence of obstructive sleep apnoea in women with polycystic ovary syndrome: a systematic review and meta-analysis

Research output: Contribution to journalReview article

Authors

  • Hassan Kahal
  • Ioannis Kyrou
  • Olalekan A Uthman
  • Anna Brown
  • Samantha Johnson
  • Peter D H Wall
  • Andrew Metcalfe
  • David G Parr
  • Harpal S Randeva

Colleges, School and Institutes

External organisations

  • Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, United Kingdom.
  • Centre of Applied Biological and Exercise Sciences (ABES), Faculty of Health and Life Sciences, Coventry University, Coventry, CV1 5FB, UK.
  • Division of Health Sciences, Warwick - Centre for Applied Health Research and Delivery (WCAHRD), Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom.
  • Library and Knowledge Services, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, United Kingdom.
  • University of Warwick Library, University of Warwick, Coventry CV4 7AL, United Kingdom.
  • Department of Warwick Orthopaedics, Warwick Medical School, University of Warwick, Coventry CV2 2DX, United Kingdom.
  • Department of Respiratory Medicine, Cardio-Respiratory Division, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK.
  • Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom.
  • Centre of Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham United Kingdom.
  • Department of Diabetes and Endocrinology, Birmingham Heartlands Hospital, Birmingham, UK.
  • Centre of Applied Biological and Exercise Sciences (ABES), Faculty of Health and Life Sciences, Coventry University, Coventry, CV1 5FB, UK. Harpal.Randeva@warwick.ac.uk.

Abstract

BACKGROUND: Obesity is a common risk factor for polycystic ovary syndrome (PCOS) and obstructive sleep apnoea (OSA). Both PCOS and OSA are associated with increased risk of type 2 diabetes and cardiovascular disease. Hence, it is important to determine the burden of OSA in women with PCOS.

METHODS: We searched electronic databases (MEDLINE, Embase, CINAHL, PsycINFO, Scopus, Web of Science, OpenGrey, CENTRAL), conference abstracts, and reference lists of relevant articles, up to January 2019. No restriction for language or publication status. Studies that examined the presence of OSA in women with PCOS using polysomnography and/or level III devices were eligible for inclusion.

RESULTS: Seventeen studies involving 648 participants were included. Our meta-analysis showed that 35.0% (95% CI 22.2-48.9%) of women with PCOS had OSA. This prevalence was not affected by variation in PCOS definition between studies. Approximately one-tenth of the variation in OSA prevalence was related to differences in study population (higher in adults than adolescents and mixed populations), and around one-tenth was related to sample size (higher in smaller studies). OSA prevalence was markedly higher in obese versus lean women with PCOS, and in women with PCOS compared to controls (odds ratio = 3.83, 95% CI 1.43-10.24, eight studies, 957 participants (349 PCOS and 608 controls)). However, most of the studies were at high risk of selection bias, did not account for important confounders, included predominantly women with class II obesity, and were conducted in one country (USA).

CONCLUSIONS: Future studies need to examine the true prevalence of OSA in a more representative sample of women with PCOS. Nevertheless, our results suggest that the prevalence of OSA in women with PCOS and obesity is high and clinicians should have a high index of suspicion of OSA in these women.

Details

Original languageEnglish
JournalSleep and Breathing
Early online date20 May 2019
Publication statusE-pub ahead of print - 20 May 2019