A narrative review on obstructive sleep apnea in China: A sleeping giant in disease pathology

We review the aspects of obstructive sleep apnea (OSA), which is the most common respiratory disorder of sleep in China. Approximately 176 million people in China have apnea/hypopnea index ≥5/h, ranking first among the ten countries with the highest prevalence rates. Two-thirds of patients do not receive treatment at all or withdraw after only brief treatment in a survey nested in two centers in China. Drowsiness and progressive cognitive impairment related to OSA decrease work performance and add to workplace errors and accidents. Many patients with OSA remain undiagnosed. Untreated OSA increases the risk of developing cardiovascular diseases and metabolic diseases. Undiagnosed and untreated OSA patients place a great burden on healthcare costs and services, and thus enormous economic burdens across most countries across the world, due to the global epidemic of obesity, an important contributor to OSA. Continuous positive airway pressure is the first-line treatment for OSA in China; however, adherence levels are poor. Effective and less labor-intensive methods that improve adherence need to be further investigated. Traditional Chinese medicine and acupuncture are promising treatments but with unproven efficacy.