Obstructive sleep apnea risk and associated factors among patients with type 2 diabetes mellitus in Africa: systematic review and meta-analysis

Although obstructive sleep apnea affects people all across the world, there is limited information about the conditions in developing countries, notably in Africa. This study was conducted to address the aforementioned gaps by assessing the prevalence and determinants of obstructive sleep apnea risk among patients with type 2 diabetes mellitus in Africa.

To strengthen the credibility and transparency of the study the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA—P 2015) guideline were utilized for the review. Two independent reviewers searched electronic databases such as PubMed, Science Direct, and African Journal Online. The researchers used Microsoft Excel for initial data import and STATA software for statistical analysis. Cochran’s Q test was used to assess the presence of significant statistical heterogeneity I² statistic also used to quantify the degree of heterogeneity.

Electronic searches produced a total of 1072 papers. The study estimates that the pooled prevalence of OSA risk among patients with type 2 diabetes mellitus in Africa is 41.13% (95% CI: 17.95–54.30, I² = 89.4%). There was significant heterogeneity among the selected studies (Q test P < 0.001) and I² (I² = 89.4%). Hypertension (AOR = 4.07, 95%CI: 2.84, 5.81), being male (AOR = 3.06, 95%CI: 0.97, 9.62), body mass index of ≥ 30 kg/m² (AOR = 3.05, 95%CI: 0.86, 10.83) and neck circumference of 40 cm (AOR = 8.55, 95%CI: 4.83, 15.12) were factors associated with obstructive sleep apnea risk among patients with type 2 diabetes mellitus.

The study found a high prevalence of high-risk obstructive sleep apnea risk among patients with type 2 diabetes mellitus. Male gender, body mass index of ≥ 30 kg/m² (obesity), neck circumference of > 40 cm and comorbid hypertension were significantly associated with obstructive sleep apnea risk among the study participants. The study emphasizes the importance of integrating obstructive sleep apnea screening and evaluation procedures into routine follow-up care for patients with type 2 diabetes mellitus.