03293nas a2200469 4500008004100000022001400041245010500055210006900160260001600229300001200245490000800257520198200265653001002247653001602257653000902273653002202282653001902304653003402323653001102357653001102368653000902379653001602388653001202404653003002416653003002446653001702476653001602493653002602509653001202535100001702547700001702564700001802581700001902599700002002618700002402638700002402662700001702686700001802703700002302721710004402744856003502788 2002 eng d a0003-992600aPredictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study.0 aPredictors of sleepdisordered breathing in communitydwelling adu c2002 Apr 22 a893-9000 v1623 a
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.
10aAdult10aAge Factors10aAged10aAged, 80 and over10aCohort Studies10aContinental Population Groups10aFemale10aHumans10aMale10aMiddle Aged10aObesity10aPredictive Value of Tests10aResidence Characteristics10aRisk Factors10aSex Factors10aSleep Apnea Syndromes10aSnoring1 aYoung, Terry1 aShahar, Eyal1 aNieto, Javier1 aRedline, Susan1 aNewman, Anne, B1 aGottlieb, Daniel, J1 aWalsleben, Joyce, A1 aFinn, Laurel1 aEnright, Paul1 aSamet, Jonathan, M1 aSleep Heart Health Study Research Group uhttps://chs-nhlbi.org/node/686