Representation of race and sex in maxillomandibular advancement sleep apnea publications - a systematic review.

OBJECTIVE

Obstructive sleep apnea (OSA) is a highly prevalent disorder, and maxillomandibular advancement surgery is one of many treatment modalities. However, the representation of race/ethnicity and sex in maxillomandibular advancement sleep apnea publications is unknown. This study aims to compare race/ethnicity and sex demographics in maxillomandibular advancement sleep apnea publications to known OSA demographics.

METHODS

Using three databases (PubMed, MEDLINE, Ovid), a systematic review was performed in accordance with the PRISMA guidelines to identify studies published between 2011 and 2020 investigating sleep outcomes following maxillomandibular advancement surgery. Racial, ethnic, and sex data of enrolled subjects were analyzed.

RESULTS

The 35 included studies comprised 840 patients, of which 643 (76.5%) were male, exceeding the estimated 68% population prevalence of OSA in males (p-value <0.0001). Only five studies (14%) reported race/ethnicity data. Moreover, the composition of the included sample population differed significantly from US Census data (p-value <0.0001).

CONCLUSIONS

There is an overrepresentation of the male sex, and a paucity of race/ethnicity data in maxillomandibular advancement sleep apnea publications, particularly among studies performed in the US. Future studies should strive for better demographic documentation and include participants representative of the population of interest to reduce inclusion bias and promote generalizable treatment options.