@article {636,
	title = {Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study.},
	journal = {Am J Respir Crit Care Med},
	volume = {163},
	year = {2001},
	month = {2001 Jan},
	pages = {19-25},
	abstract = {<p>Disordered breathing during sleep is associated with acute, unfavorable effects on cardiovascular physiology, but few studies have examined its postulated association with cardiovascular disease (CVD). We examined the cross-sectional association between sleep- disordered breathing and self-reported CVD in 6,424 free-living individuals who underwent overnight, unattended polysomnography at home. Sleep-disordered breathing was quantified by the apnea-hypopnea index (AHI)-the average number of apneas and hypopneas per hour of sleep. Mild to moderate disordered breathing during sleep was highly prevalent in the sample (median AHI: 4.4; interquartile range: 1.3 to 11.0). A total of 1,023 participants (16\%) reported at least one manifestation of CVD (myocardial infarction, angina, coronary revascularization procedure, heart failure, or stroke). The multivariable-adjusted relative odds (95\% CI) of prevalent CVD for the second, third, and fourth quartiles of the AHI (versus the first) were 0.98 (0.77-1.24), 1.28 (1.02-1.61), and 1.42 (1.13-1.78), respectively. Sleep-disordered breathing was associated more strongly with self-reported heart failure and stroke than with self-reported coronary heart disease: the relative odds (95\% CI) of heart failure, stroke, and coronary heart disease (upper versus lower AHI quartile) were 2.38 (1.22-4.62), 1.58 (1.02- 2.46), and 1.27 (0.99-1.62), respectively. These findings are compatible with modest to moderate effects of sleep-disordered breathing on heterogeneous manifestations of CVD within a range of AHI values that are considered normal or only mildly elevated.</p>},
	keywords = {Aged, Cardiovascular Diseases, Cohort Studies, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Sleep Apnea Syndromes},
	issn = {1073-449X},
	doi = {10.1164/ajrccm.163.1.2001008},
	author = {Shahar, E and Whitney, C W and Redline, S and Lee, E T and Newman, A B and Nieto, F J and O{\textquoteright}Connor, G T and Boland, L L and Schwartz, J E and Samet, J M}
}
