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Association between obstructive sleep apnea and health-related quality of life in untreated adults: a systematic review

  • Sleep Breathing Physiology and Disorders • Review
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Abstract

Purpose

The objective of this systematic review was to answer the question: “Is there association between obstructive sleep apnea (OSA) and health-related quality of life (HRQoL) in untreated adults?”

Methods

We included observational studies that evaluated the health-related quality of life of patients with OSA vs control groups, through generic and disease-specific questionnaires. The searches were conducted in six databases: Embase, Lilacs, PsycINFO, PubMed, Scopus, and Web of Science. Additional search in the grey literature and hand search were performed, and also experts were consulted. Risk of bias was performed by using Joanna Briggs Institute Critical Appraisal Checklist for cross-sectional, cohort, and case-control studies. We analyzed the data using a narrative synthesis. The Grading of Recommendations Assessment, Development, and Evaluation evidence profile was used to verify the overall certainty of the assessed evidence.

Results

Nineteen studies were included for qualitative analysis. Generic questionnaires showed worse HRQoL in the OSA group compared to the control group in at least one domain of the HRQoL questionnaires. The affected domains that showed statistical and clinically relevant differences were physical functioning, physical role, pain, general health, vitality, emotional role, and mental health. The certainty of evidence assessment was very low.

Conclusion

The available literature suggests that OSA in untreated adults is associated with worse HRQoL. However, this association seems to disappear when we consider only studies adjusted for related covariates.

Registration

CRD42018114746.

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Data Availability

Data are available in the manuscript and supplementary file.

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Acknowledgements

The authors thank Maria Gorete Manteguti Savi for the instructions regarding the search strategy in this review’s first stage. We thank the authors Sarah L. Appleton and Edmundo Rosales-Mayor, who kindly replied to the e-mails.

Code availability

Not applicable.

Funding

PP is supported by CAPES (Coordination for the Improvement of Higher Education Personnel), Ministry of Education, Brazil. DG is supported in part by National Institutes of Health grants 1R01HL130984 and R56 HL140548.

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Authors and Affiliations

  1. Department of Dentistry, Brazilian Centre for Evidence-Based Research, Health Sciences Center, Federal University of Santa Catarina, Campus Universitário Caixa Postal 476 – Trindade, Florianópolis, Santa Catarina, 88040-900, Brazil

    Patrícia Pauletto, Jéssica Conti Réus, Carla Massignan, Ana Luiza Curi Hallal, André Luís Porporatti & Graziela De Luca Canto

  2. Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil

    Michele Bolan

  3. Department of Dentistry, Federal University of Brasília, Brasilia, Distrito Federal, Brazil

    Carla Massignan

  4. Department of Dentistry, University of Alberta, Edmonton, Canada

    Carlos Flores-Mir

  5. Baía Sul Research Institute, Florianópolis, Santa Catarina, Brazil

    Israel Maia

  6. Department of Child Health, University of Missouri School of Medicine, Columbia, MO, 65201, USA

    David Gozal

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  1. Patrícia Pauletto
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  2. Jéssica Conti Réus
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Contributions

MSc. Patrícia Pauletto worked on study conceptualization, design, data collection, data analysis, drafted the initial manuscript, and approved the final manuscript as submitted.

Jéssica Conti Réus worked on study conceptualization, design, data collection, data analysis, drafted the initial manuscript, and approved the final manuscript as submitted.

Dr. Michele Bolan worked on study conceptualization, design, data collection, data analysis, and approved the final manuscript as submitted.

Dr. Carla Massignan worked on study conceptualization, design, data collection, data analysis, and approved the final manuscript as submitted.

Dr. Carlos Flores-Mir worked on study conceptualization, data analysis and critically reviewed the manuscript, and approved the final manuscript as submitted.

MSc. Israel Maia worked on study conceptualization, design, data analysis, and critically reviewed the manuscript and approved the final manuscript as submitted.

Dr. David Gozal worked on study conceptualization, design, data analysis, and critically reviewed the manuscript and approved the final manuscript as submitted.

Dr. Ana Luiza Curi Hallal worked on study conceptualization, design, data analysis, and critically reviewed the manuscript and approved the final manuscript as submitted.

Dr. André Luis Porporatti worked on study conceptualization, data analysis and critically reviewed the manuscript, and approved the final manuscript as submitted.

Dr. Graziela De Luca Canto worked on study conceptualization, data analysis and critically reviewed the manuscript, and approved the final manuscript as submitted.

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Correspondence to Patrícia Pauletto.

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Pauletto, P., Réus, J.C., Bolan, M. et al. Association between obstructive sleep apnea and health-related quality of life in untreated adults: a systematic review. Sleep Breath 25, 1773–1789 (2021). https://doi.org/10.1007/s11325-021-02323-1

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