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A new study published today (Thursday) in the medical journal Thorax has revealed a 'significant and concerning' mismatch between the predicted prevalence of the common sleep-related respiratory condition 'obstructive sleep apnoea' (OSA), and the availability of services with which to diagnose and treat it.
The research, conducted by the British Lung Foundation with clinicians from Guys and St Thomas' Hospital in London, analysed data for a range of factors commonly associated with OSA in order to predict, for the first time, variations in relative OSA prevalence between NHS administrative areas throughout UK*. This was then mapped against data on the spread of UK sleep centres - also collated for the first time for the study.
Wales, parts of East Anglia, East Yorkshire, Lincolnshire, and the North-East were revealed to be areas with high predicted OSA prevalence. Large urban areas in England and Scotland, and counties to the west of London were amongst the areas with amongst the lowest predicted prevalence. This spread contrasted considerably with the availability of local sleep services for diagnosing and treating the condition, with large urban areas better served despite the lower risk of OSA, and parts of mid-Wales, the North-West and East Anglia having much lower numbers of identified sleep centres.
Although relatively easy to treat, OSA is linked with a range of serious health concerns including stroke, heart disease, depression, diabetes and high blood pressure when left undiagnosed and untreated. It can also significantly affect quality of life and ability to work, as well as increasing chances of road traffic accidents as much as seven-fold[2,3]. OSA affects people of all ages, including up to 4% of middle-aged men, 2% of middle-aged women, and 20% of those aged over 70[4,5]. However, it is estimated that around 80% of cases remain undiagnosed2. With an increasingly overweight and ageing population, it is anticipated that rates of OSA will increase in the coming years.
Dr Penny Woods, Chief Executive of the British Lung Foundation:
"The disparity between the predicted prevalence of OSA and the distribution of sleep centres with which to diagnose and treat the condition show that there is much to be done if we are to properly address the burden OSA currently places on the health of the nation.
"With rates of OSA likely to rise further with an ageing and increasingly overweight population, I hope this research will act as a wake-up call for governments and NHS bodies across the UK. We need to improve access to treatment and diagnostic services, and to raise awareness of the symptoms and dangers of untreated OSA - among medical professionals as well as the general public - if we are to successfully tackle the demands of OSA in the 21st century".
Professor Adrian Williams, Medical Advisor at the British Lung Foundation, Professor of Sleep Medicine at Guys and St Thomas' Hospital, and co-author of the study:
"Too often, a lack of awareness leads to the symptoms of OSA being not recognised, or dismissed simply as an irritation for anyone who shares a room with someone affected. However, OSA can have a severe impact on quality of life, and is associated with a range of serious health problems including heart disease, stroke, diabetes and depression.
"In most cases, OSA is easily treatable in a way that can successfully minimise the associated risks. This makes it all the more frustrating that, as highlighted by this research, it may be difficult to identify and offer treatment to those in need across large parts of the country."
Please visit the BLF website to find out more about OSA and the BLF's OSA campaign, or to undertake a free test to see whether you are displaying some of the symptoms of OSA.
Video of a three-year old boy with sleep apnoea:
Video of a middle aged man with sleep apnoea:
OSA occurs when neck and throat muscles relax when a person is asleep, causing the airway to get blocked and the breathing to be interrupted. It can cause an individual to stop breathing for a significant amount of time (a minimum of 10 seconds, but over a minute in extreme cases). This pause in breath can happen hundreds of times a night, resulting in dips in blood oxygen levels and preventing the occurrence of deep sleep. Symptoms include snoring, stopping breathing or struggling to breathe whilst asleep, and sleepiness during the day.
The authors collated prevalence data for five factors commonly associated with obstructive sleep apnoea (OSA), weighted them according to their predictive strength as an indicator of OSA, and plotted the data to produce the first UK maps of predicted relative OSA prevalence estimates across the country. The maps were overlaid with information on the availability of sleep services across the UK, also collated here for the first time. The data show a significant and concerning mismatch between areas in which high estimated relative OSA prevalence was predicted, and the availability of local sleep centres for diagnosing and treating the condition.
* NHS administrative areas included (NHS Health Boards (HBs) in Scotland, NHS Local Health Boards (LHBs) in Wales, NHS Health and Social Care Trusts (HSCTs) in Northern Ireland, and NHS Clinical Commissioning Groups (CCGs) in England, with predicted CCG boundaries used where final boundaries were yet to be agreed.
The BLF OSA campaign was supported with funding from founding partner Philips Respironics, and from ResMed.
1. Steier J, Martin A, Harris J, Jarrold I, Pugh D, Williams A. Predicted relative prevalence estimates for obstructive sleep apnoea and the associated healthcare provision across the UK. Thorax Online First doi 10.1136/thoraxjnl-2013-203887. 2013
2. Lee W et al: ‘Epidemiology of Obstructive Sleep Apnoea: a population-based perspective’ Expert Rev Respir Med. 2008 Jun 1;2(3):349-364.
3. IMPRESS. Service specification for investigation and treatment of OSAS. 2009
4. National Institute for Health and Clinical Excellence (NICE). Technology appraisal guidance 139: Continuous positive airway pressure for the treatment of obstructive sleep apnoea/hypopnoea syndrome. 2008
5. Martinez-Garcia MA et al. Sleep Apnoea in Patients of Elderly. Archivos de Bronconeumologia. 2010; 46 (10): 502-507
British Lung Foundation
Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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British Lung Foundation. "New research reveals 'concerning' inconsistency in UK services for dangerous sleep disorder obstructive sleep apnoea." Medical News Today. MediLexicon, Intl., 19 Sep. 2013. Web.
12 Dec. 2013. <http://www.medicalnewstoday.com/releases/266315>
British Lung Foundation. (2013, September 19). "New research reveals 'concerning' inconsistency in UK services for dangerous sleep disorder obstructive sleep apnoea." Medical News Today. Retrieved from
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