Endocrine Abstracts (2017) 50 P339 | DOI: 10.1530/endoabs.50.P339

The Prevalence of Obstructive Sleep Apnoea in women with Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis

Hassan Kahal1,2, Ioannis Kyrou1,2,3, Olalekan Uthman4, Anna Brown5, Samantha Johnson6, Peter Wall7, Andrew Metcalfe7, Abd Tahrani8,9,10 & Harpal Randeva1,2,3


1Warwick Medical School, University of Warwick, Coventry, UK; 2Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK; 3Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, UK; 4Warwick - Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK; 5Library and Knowledge Services, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK; 6University of Warwick Library, University of Warwick, Coventry, UK; 7Department of Warwick Orthopaedics, Warwick Medical School, University of Warwick, Coventry, UK; 8Institute of Metabolism and Systems Research, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK; 9Centre of Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham, UK; 10Department of Diabetes, Birmingham Heartlands Hospital, Birmingham, UK.


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.