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

TitlePredictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study.
Publication TypeJournal Article
Year of Publication2002
AuthorsYoung, T, Shahar, E, F Nieto, J, Redline, S, Newman, AB, Gottlieb, DJ, Walsleben, JA, Finn, L, Enright, P, Samet, JM
Corporate/Institutional AuthorsSleep Heart Health Study Research Group,
JournalArch Intern Med
Volume162
Issue8
Pagination893-900
Date Published2002 Apr 22
ISSN0003-9926
KeywordsAdult, Age Factors, Aged, Aged, 80 and over, Cohort Studies, Continental Population Groups, Female, Humans, Male, Middle Aged, Obesity, Predictive Value of Tests, Residence Characteristics, Risk Factors, Sex Factors, Sleep Apnea Syndromes, Snoring
Abstract<p><b>BACKGROUND: </b>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.</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p>
DOI10.1001/archinte.162.8.893
Alternate JournalArch Intern Med
PubMed ID11966340
Grant ListU01HL53916 / HL / NHLBI NIH HHS / United States
U01HL53931 / HL / NHLBI NIH HHS / United States
U01HL53937 / HL / NHLBI NIH HHS / United States
U01HL53938 / HL / NHLBI NIH HHS / United States
U01HL53940 / HL / NHLBI NIH HHS / United States
U01HL53941 / HL / NHLBI NIH HHS / United States
U11HL5394 / HL / NHLBI NIH HHS / United States