Background: Obesity is a common risk factor for obstructive sleep apnoea (OSA) and polycystic ovary syndrome (PCOS).
Objective: To examine the prevalence of OSA in women with PCOS.
Search sources: Electronic databases [Medline, Embase, Cinahl, PsycInfo, Scopus, Web of Science, Opengrey, and Cochrane Central Register of Controlled Trials], conference abstracts, and reference lists of relevant articles. The search was not restricted by language or publication status.
Main results: Fifteen studies involving 568 participants were included. OSA prevalence in women with PCOS was 36.1% (95% CI: 22.4% 51.0%).
There was a trend for higher OSA prevalence in studies from the USA than those from other countries (43.2% v. 25.2%), and in women compared to adolescent girls with PCOS (46.8% vs. 21.2%), though not statistically significant. The definition of PCOS did not significantly alter OSA prevalence.
In the two studies that stratified prevalence estimates by body mass index, OSA prevalence was 38% higher in women with PCOS and obesity compared to those without obesity (prevalence difference: +37.9%, 95% CI: 15.0% - 60.9%).
Limitations: The majority of studies were found to be at high risk of selection bias; did not account for important confounders; included largely women with class II obesity; and were conducted in the USA. None of the studies were population based. There was a statistically significant heterogeneity among the studies.
Conclusions: OSA appears to have a high prevalence in obese women with PCOS. The true prevalence of OSA in women with PCOS is not known. Whether women with PCOS are at increased risk of OSA, compared to women without PCOS, is also unknown. Well conducted, large, cohort studies are required to assess the true prevalence of OSA in women with PCOS, and to examine the natural history and impact of OSA in women with PCOS.