A Systematic Review of Obstructive Sleep Apnea in Indigenous and First Nations Peoples Worldwide

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ID: 322577
2026
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Abstract
Abstract Study Objectives Emerging evidence indicates that Indigenous peoples experience disproportionately high rates of obstructive sleep apnea (OSA). This systematic review aimed to examine OSA prevalence, contributing factors, and intervention or treatment outcomes among Indigenous peoples worldwide. Methods We systematically searched PubMed, Embase, CINAHL, Cochrane CENTRAL, ATSI Health, Web of Science and PsycINFO (last searched 30 June, 2025), and grey literature for original research involving Indigenous peoples (≥18 years) diagnosed with OSA via self-report or laboratory-based measures (e.g., polysomnography). Data extraction focused on study characteristics and key findings. Methodological quality was assessed using NIH tools, and cultural appropriateness was evaluated using the CREATE Aboriginal and Torres Strait Islander Quality Appraisal Tool. A narrative synthesis was conducted. Results From 599 records, 41 studies from six countries were included. OSA prevalence among Indigenous populations varied widely (community-based samples, 6.5%-69%; referred samples, 85-95%; self-reported diagnosis, 1.2%-8.4%; hospital audit diagnoses, 0.8-11.4%), with only one study reporting a robust population-based estimate (~6.5% among Māori). Severe cases predominated in referred samples. Factors associated with OSA included male sex, age, BMI, neck circumference, craniofacial and geographic factors, and symptoms such as snoring. Treatment evidence was limited to CPAP, with low adherence. Conclusions Findings suggests that OSA is common among Indigenous peoples across diverse settings. However, prevalence estimates are heterogeneous and limited by differences in study design, sampling frame, and diagnostic approaches, with most evidence based on referred clinical samples. Improving awareness and culturally responsive screening and management may improve outcomes. Sleep health among Indigenous peoples warrants a higher priority in research, policy and practice. Registration The protocol for this systematic review was registered with Prospero (CRD42024466932).
Reference Key
openalex_W7170139759 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Shannon Edmed, Daniel Sullivan, Michelle Olaithe, Scott Coussens, P I Terrill, D Mann, Danielle Wilson, Wayne Williams, Danny J. Eckert, S Kalmadka, S Gadam, Yaqoot Fatima
Journal SLEEP Advances
Year 2026
DOI
10.1093/sleepadvances/zpag080
URL
https://doi.org/10.1093/sleepadvances/zpag080
Keywords Keywords not found

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