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

Terry Young, Eyal Shahar, F. Javier Nieto, Susan Redline, Anne B. Newman, Daniel J. Gottlieb, Joyce A. Walsleben, Laurel Finn, Paul Enright, Jonathan M. Samet

Research output: Contribution to journalArticle

868 Citations (Scopus)

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)893-900
Number of pages8
JournalArchives of Internal Medicine
Volume162
Issue number8
StatePublished - Apr 22 2002
Externally publishedYes

Fingerprint

Independent Living
Sleep Apnea Syndromes
Apnea
Sleep
Health
Snoring
Respiration
Body Mass Index
Neck
Population
Polysomnography
Obesity
Logistic Models
Odds Ratio
Demography
Confidence Intervals

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Young, T., Shahar, E., Nieto, F. J., Redline, S., Newman, A. B., Gottlieb, D. J., ... Samet, J. M. (2002). Predictors of sleep-disordered breathing in community-dwelling adults: The Sleep Heart Health Study. Archives of Internal Medicine, 162(8), 893-900.

Predictors of sleep-disordered breathing in community-dwelling adults : The Sleep Heart Health Study. / Young, Terry; Shahar, Eyal; Nieto, F. Javier; Redline, Susan; Newman, Anne B.; Gottlieb, Daniel J.; Walsleben, Joyce A.; Finn, Laurel; Enright, Paul; Samet, Jonathan M.

In: Archives of Internal Medicine, Vol. 162, No. 8, 22.04.2002, p. 893-900.

Research output: Contribution to journalArticle

Young, T, Shahar, E, Nieto, FJ, Redline, S, Newman, AB, Gottlieb, DJ, Walsleben, JA, Finn, L, Enright, P & Samet, JM 2002, 'Predictors of sleep-disordered breathing in community-dwelling adults: The Sleep Heart Health Study', Archives of Internal Medicine, vol. 162, no. 8, pp. 893-900.
Young, Terry ; Shahar, Eyal ; Nieto, F. Javier ; Redline, Susan ; Newman, Anne B. ; Gottlieb, Daniel J. ; Walsleben, Joyce A. ; Finn, Laurel ; Enright, Paul ; Samet, Jonathan M. / Predictors of sleep-disordered breathing in community-dwelling adults : The Sleep Heart Health Study. In: Archives of Internal Medicine. 2002 ; Vol. 162, No. 8. pp. 893-900.
@article{d57794043acb4239a8fa100a78545611,
title = "Predictors of sleep-disordered breathing in community-dwelling adults: The Sleep Heart Health Study",
abstract = "Background: 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. Methods: 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. Results: 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. Conclusions: 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.",
author = "Terry Young and Eyal Shahar and Nieto, {F. Javier} and Susan Redline and Newman, {Anne B.} and Gottlieb, {Daniel J.} and Walsleben, {Joyce A.} and Laurel Finn and Paul Enright and Samet, {Jonathan M.}",
year = "2002",
month = "4",
day = "22",
language = "English (US)",
volume = "162",
pages = "893--900",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "8",

}

TY - JOUR

T1 - Predictors of sleep-disordered breathing in community-dwelling adults

T2 - The Sleep Heart Health Study

AU - Young, Terry

AU - Shahar, Eyal

AU - Nieto, F. Javier

AU - Redline, Susan

AU - Newman, Anne B.

AU - Gottlieb, Daniel J.

AU - Walsleben, Joyce A.

AU - Finn, Laurel

AU - Enright, Paul

AU - Samet, Jonathan M.

PY - 2002/4/22

Y1 - 2002/4/22

N2 - Background: 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. Methods: 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. Results: 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. Conclusions: 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.

AB - Background: 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. Methods: 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. Results: 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. Conclusions: 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.

UR - http://www.scopus.com/inward/record.url?scp=0037156411&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037156411&partnerID=8YFLogxK

M3 - Article

C2 - 11966340

AN - SCOPUS:0037156411

VL - 162

SP - 893

EP - 900

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 8

ER -