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Relation of sleepiness to respiratory disturbance index: the Sleep Heart Health Study.

TitleRelation of sleepiness to respiratory disturbance index: the Sleep Heart Health Study.
Publication TypeJournal Article
Year of Publication1999
AuthorsGottlieb, DJ, Whitney, CW, Bonekat, WH, Iber, C, James, GD, Lebowitz, M, Nieto, FJ, Rosenberg, CE
JournalAm J Respir Crit Care Med
Date Published1999 Feb
KeywordsAged, Cardiovascular Diseases, Cross-Sectional Studies, Disorders of Excessive Somnolence, Female, Humans, Male, Middle Aged, Polysomnography, Respiration, Retrospective Studies, Severity of Illness Index, Sleep Apnea Syndromes, Surveys and Questionnaires
Abstract<p>Obstructive sleep apnea syndrome is a well recognized cause of excessive sleepiness; however, the relation of sleepiness to mild sleep-disordered breathing (SDB), which affects as much as half the adult population, is uncertain. In order to explore this relation, we conducted a cross-sectional cohort study of community-dwelling adults participating in the Sleep Heart Health Study, a longitudinal study of the cardiovascular consequences of SDB. The study sample comprises 886 men and 938 women, with a mean age of 65 (SD 11) yr. Sleepiness was quantified using the Epworth Sleepiness Scale (ESS). Sleep-disordered breathing was quantified by the respiratory disturbance index (RDI), defined as the number of apneas plus hypopneas per hour of sleep, measured during in-home polysomnography. When RDI was categorized into four groups (< 5, 5 to < 15, 15 to < 30, >/= 30), a significantly progressive increase in mean ESS score was seen across all four levels of SDB, from 7.2 (4.3) in subjects with RDI < 5 to 9.3 (4.9) in subjects with RDI >/= 30 (p < 0.001). There was no significant modification of this effect by age, sex, body mass index, or evidence of chronic restriction of sleep time or periodic limb movement disorder. The percentage of subjects with excessive sleepiness, defined as an ESS score >/= 11, increased from 21% in subjects with RDI < 5 to 35% in those with RDI >/= 30 (p < 0. 001). We conclude that SDB is associated with excess sleepiness in community-dwelling, middle-aged and older adults, not limited to those with clinically apparent sleep apnea.</p>
Alternate JournalAm. J. Respir. Crit. Care Med.
PubMed ID9927364
Grant ListU01HL53940 / HL / NHLBI NIH HHS / United States
U01HL53941 / HL / NHLBI NIH HHS / United States
U0HL53938 / HL / NHLBI NIH HHS / United States