A Systematic Review and Meta-Analysis of Prevalence of Obstructive Sleep Apnea in Iranian Patients with Cardiovascular Disease: Perspective of Prevention, Care and Treatment

Obstructive sleep apnea (OSA) is a chronic breathing disorder during sleep. It is prevalent among patients with cardiovascular disease (CVD) and can increase its severity and mortality. Various studies have reported different results in Iran. This systematic review and meta-analysis aimed to determine the prevalence of OSA in Iranian patients with CVD.

In this study, eight papers published in Persian and English languages were reviewed. The articles were searched using the following keywords and all their possible combinations: “obstructive sleep apnea”, “sleep-disordered breathing”, “sleep apnea”, “OSA”, “cardiovascular disease”, “hypertension”, and “Iran”. Scientific databases, including the Scientific Information Database (SID), Magiran, Web of Science, PubMed, and Scopus, were searched with no time limitations. Data were analyzed using a meta-analysis and a random effects model. Besides, heterogeneity was assessed using the I2 statistic. Data analysis was performed in Stata version 11.

The review of eight studies, with a total sample size of 1646 patients, showed that the prevalence of OSA was 59.21% (95% CI: 53.11-65.32) among CVD patients. Also, the prevalence of OSA was higher in men (60.12%; 95% CI: 60.12-82.54) than in women (41.01%; 95% CI: 16.08-65.94). Besides, it was estimated to be higher based on the STOP and STOP-BANG questionnaires (63%; 95% CI: 52.89-73.10) as compared to the Berlin questionnaire (56.63%; 95% CI: 49.20-64.06).

More than half of Iranian CVD patients have OSA. Therefore, identifying high-risk patients to reduce the adverse effects of sleep apnea seems necessary.