Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study.

By T. Young, E. Shahar, F. Nieto, Susan Redline, Anne B. Newman, D. Gottlieb, J. Walsleben, L. Finn, P. Enright, J. Samet. Archives of Internal Medicine, 2002

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BACKGROUND Sleep-disordered breathing (SDB) is common, but largely undiagnosed in the general population. Information on demographic patterns of SDB occurrence and its predictive factors in the general population is needed to target high-risk groups that may benefit from diagnosis. METHODS The sample comprised 5615 community-dwelling men and women aged between 40 and 98 years who were enrolled in the Sleep Heart Health Study. Data were collected by questionnaire, clinical examinations, and in-home polysomnography. Sleep-disordered breathing status was based on the average number of apnea and hypopnea episodes per hour of sleep (apnea-hypopnea index [AHI]). We used multiple logistic regression modeling to estimate cross-sectional associations of selected participant characteristics with SDB defined by an AHI of 15 or greater. RESULTS Male sex, age, body mass index, neck girth, snoring, and repeated breathing pause frequency were independent, significant correlates of an AHI of 15 or greater. People reporting habitual snoring, loud snoring, and frequent breathing pauses were 3 to 4 times more likely to have an AHI of 15 or greater vs an AHI less than 15, but there were weaker associations for other factors with an AHI of 15 or greater. The odds ratios (95% confidence interval) for an AHI of 15 or greater vs an AHI less than 15 were 1.6 and 1.5, respectively, for 1-SD increments in body mass index and neck girth. As age increased, the magnitude of associations for SDB and body habitus, snoring, and breathing pauses decreased. CONCLUSIONS A significant proportion of occult SDB in the general population would be missed if screening or case finding were based solely on increased body habitus or male sex. Breathing pauses and obesity may be particularly insensitive for identifying SDB in older people. A better understanding of predictive factors for SDB, particularly in older adults, is needed.

Subfields: Endocrine and Autonomic Systems, Experimental and Cognitive Psychology, Physiology

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In Endocrine and Autonomic Systems

In Experimental and Cognitive Psychology

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Citations in the corpus

Excess weight and sleep-disordered breathing. (2005, background): “(56) Multisite (Sleep Heart Health Study) AHI 15 Quartiles, BMI In-home PSG 1 (16–24) 10 n 5,615 M, W 2 (24–28) 13 3 (28–32) 17 40–98 yr 4 (32–59) 32 Waist-to-hip girth ratio 1 W (0.”
Epidemiology of obstructive sleep apnea: a population health perspective. (2002, background): “Ip and coworkers (32) noted that whereas BMI and other measures of body habitus were associated with OSA in the Hong Kong study, the correlations were weaker than those seen in studies of white subjects.”
Risk factors for obstructive sleep apnea in adults. (2004, background): “However, this increase plateaus after 65 years.(4,5,15) It is possible that the observed plateau is due to a relative increase in mortality from OSA after 65 years, but data to address this are sparse.”