The occurrence of sleep-disordered breathing among middle-aged adults.
Level 3 - non-randomized controlled study
Cross-sectional analysis of a prospective population-based cohort using objective overnight polysomnography.
PubMed 8464434 · doi:10.1056/NEJM199304293281704
What was done
Researchers analyzed data from the Wisconsin Sleep Cohort Study to determine the prevalence of undiagnosed sleep-disordered breathing and its associated risk factors. A random sample of 602 employed adults (men and women aged 30 to 60 years) underwent overnight laboratory polysomnography to measure their apnea-hypopnea score (events per hour of sleep). Prevalence was evaluated across three cutoff thresholds (≥5, ≥10, and ≥15 events/hour), and logistic regression was used to evaluate risk factor associations.
What was found
Sleep-disordered breathing (apnea-hypopnea score ≥5) was present in an estimated 9% of women and 24% of men. The full sleep apnea syndrome (apnea-hypopnea score ≥5 accompanied by daytime hypersomnolence) was estimated to affect 2% of women and 4% of men in the middle-aged work force. Male sex and obesity were strongly associated with sleep-disordered breathing. Habitual snorers of both sexes had a higher prevalence of apnea-hypopnea scores ≥15.
Why it matters
This study demonstrated that undiagnosed sleep-disordered breathing is common in the general working-age population—particularly among men and substantially higher than previously recognized among women—establishing it as an important public health issue.
Limits
The study was restricted to an employed cohort of state workers aged 30 to 60, which may limit generalizability to unemployed, retired, older, or more ethnically diverse populations. The cross-sectional prevalence assessment cannot determine longitudinal health outcomes or directional causality with associated symptoms.
Cited by
- supports Approximately 1 in 4 to 5 men over the age of 30 has sleep-related breathing issues, rising to about 50% for men with a BMI over 30.
- supports Sleep apnea affects approximately 1 in 15 to 20 women.