Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study

Abstract

Summary Background Sleep-disordered breathing is associated with major morbidity and mortality. However, its prevalence has mainly been selectively studied in populations at risk for sleep-disordered breathing or cardiovascular diseases. Taking into account improvements in recording techniques and new criteria used to define respiratory events, we aimed to assess the prevalence of sleep-disordered breathing and associated clinical features in a large population-based sample. Methods Between Sept 1, 2009, and June 30, 2013, we did a population-based study (HypnoLaus) in Lausanne, Switzerland. We invited a cohort of 3043 consecutive participants of the CoLaus/PsyCoLaus study to take part. Polysomnography data from 2121 people were included in the final analysis. 1024 (48%) participants were men, with a median age of 57 years (IQR 49–68, range 40–85) and mean body-mass index (BMI) of 25·6 kg/m2 (SD 4·1). Participants underwent complete polysomnographic recordings at home and had extensive phenotyping for diabetes, hypertension, metabolic syndrome, and depression. The primary outcome was prevalence of sleep-disordered breathing, assessed by the apnoea-hypopnoea index. Findings The median apnoea-hypopnoea index was 6·9 events per h (IQR 2·7–14·1) in women and 14·9 per h (7·2–27·1) in men. The prevalence of moderate-to-severe sleep-disordered breathing (≥15 events per h) was 23·4% (95% CI 20·9–26·0) in women and 49·7% (46·6–52·8) in men. After multivariable adjustment, the upper quartile for the apnoea-hypopnoea index (>20·6 events per h) was associated independently with the presence of hypertension (odds ratio 1·60, 95% CI 1·14–2·26; p=0·0292 for trend across severity quartiles), diabetes (2·00, 1·05–3·99; p=0·0467), metabolic syndrome (2·80, 1·86–4·29; p<0·0001), and depression (1·92, 1·01–3·64; p=0·0292). Interpretation The high prevalence of sleep-disordered breathing recorded in our population-based sample might be attributable to the increased sensitivity of current recording techniques and scoring criteria. These results suggest that sleep-disordered breathing is highly prevalent, with important public health outcomes, and that the definition of the disorder should be revised. Funding Faculty of Biology and Medicine of Lausanne, Lausanne University Hospital, Swiss National Science Foundation, Leenaards Foundation, GlaxoSmithKline, Ligue Pulmonaire Vaudoise.

Using the Berlin Questionnaire to Predict Obstructive Sleep Apnea in the General Population

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Predictors of long-term adherence to continuous positive airway pressure in patients with obstructive sleep apnoea and acute coronary syndrome

“…Obstructive sleep apnoea (OSA) is a highly prevalent respiratory disorder that affects 6-13% of the general population or more, depending on gender and age group (1,2). OSA is characterized by recurrent episodes of upper airway collapse that result in sleep fragmentation, intermittent hypoxia and the disruption of sleep architecture.…”

Obstructive sleep apnoea in patients undergoing cardiac surgery: Screening, postoperative outcomes and perioperative care

“…OSA is the most common form of sleep disordered breathing. OSA is common 1 and the reported prevalence has increased in the last two decades 1 with the new data reported mainly in European population of adults 40-85 years old showing that at least mild OSA (apnoea-hypopnoea index ≥5) was present in 84% of men and 61% of women and at least moderate disease (apnoea-hypopnoea index ≥15) was present in 50% of men and 23 % of women 2 . OSA and cardiac disease share some common risk factors and in patients undergoing coronary artery bypass graft (CABG) procedures reported prevalence is high, ranging between 41 and 87% [3][4][5] .High proportions of patients may present for surgery without a previous diagnosis of OSA 6,7 and may be at risk of worse postoperative outcomes 8 .…”