Peppard · American journal of epidemiology 2013 · prospective cohort study and statistical modeling · n=1520

Increased prevalence of sleep-disordered breathing in adults.

Cited 4653 times in the scientific literature.

Level 3 - non-randomized controlled study

Prospective cohort study with statistical modeling and extrapolation to national survey data

PubMed 23589584 · doi:10.1093/aje/kws342 · record verified 2026-08-27

What was done

Using data from the Wisconsin Sleep Cohort Study (an ongoing community-based cohort of employed Wisconsin adults aged 30–70 years established in 1988, n = 1,520 with baseline polysomnography and repeat studies at 4-year intervals), researchers modeled sleep-disordered breathing prevalence as a function of age, sex, and body mass index (BMI). These estimates were then extrapolated to US population BMI distributions derived from the National Health and Nutrition Examination Survey (NHANES) for 1988–1994 and 2007–2010. Moderate to severe sleep-disordered breathing was defined as an apnea-hypopnea index (AHI) ≥ 15 events/hour.

What was found

Estimated US prevalence rates for moderate to severe sleep-disordered breathing (AHI ≥ 15) in 2007–2010 were: - 10% (95% CI: 7, 12) among men aged 30–49 years - 17% (95% CI: 15, 21) among men aged 50–70 years - 3% (95% CI: 2, 4) among women aged 30–49 years - 9% (95% CI: 7, 11) among women aged 50–70 years These estimates represent relative increases of between 14% and 55% across subgroups over the past two decades.

Why it matters

This study provides updated national prevalence estimates indicating that moderate to severe sleep-disordered breathing has risen substantially in US adults over the last two decades, aligning with the obesity epidemic.

Limits

National figures rely on model-based extrapolation to NHANES data rather than direct nationwide polysomnography measurements. The primary cohort was limited to employed adults aged 30–70 years in Wisconsin, which may limit generalizability to other demographics or non-working populations.

Cited by