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. 2022 Jun 1;18(6):1503-1514.
doi: 10.5664/jcsm.9886.

Prevalence of common sleep disorders in a middle-aged community sample

Nigel McArdle  1   2 , Amy C Reynolds  3 , David Hillman  1   2 , Eric Moses  4   5 , Kath Maddison  1   2 , Phillip Melton  4   6 , Peter Eastwood  3
Affiliations

Prevalence of common sleep disorders in a middle-aged community sample

Nigel McArdle et al. J Clin Sleep Med. .

Abstract

Study objectives: There is a paucity of contemporary prevalence estimates for common sleep disorders of insomnia, obstructive sleep apnea (OSA), and restless legs syndrome. We aimed to assess the prevalence of clinically significant common sleep disorders in a middle-aged community sample.

Methods: Parents of participants in the community-based Raine Study underwent assessments between 2015 and 2017, including comprehensive questionnaires, anthropometric measures, and in-laboratory polysomnography. Clinically significant sleep disorders were defined as chronic insomnia using the Pittsburgh Sleep Symptom Questionnaire-Insomnia with duration criterion ≥ 3 months; OSA as apnea-hypopnea index ≥ 5 events/h with excessive sleepiness (Epworth Sleepiness Scale ≥ 11) or apnea-hypopnea index ≥ 15 events/h (even in the absence of symptoms); restless legs syndrome when participants endorsed the International Restless Legs Syndrome Study Group diagnostic criteria (2003) with symptoms ≥ 5 times/month involving moderate-severe distress.

Results: At least 1 sleep-related assessment was completed by 1,005 (female = 586, 58.3%) middle-aged (45-65 years) participants, 72.5% of eligible Raine Study parents. The respective prevalences for clinically significant disease in females and males were as follows: OSA, 24.0% (95% confidence interval [CI]: 20.5-27.7) and 47.3% (95% CI: 42.2-53.4); insomnia, 15.8% (95% CI: 13.1-19.0) and 9.3% (95% CI: 6.8-12.4); restless legs syndrome, 3.7% (95% CI: 2.4-5.4) and 2.2% (95% CI: 1.1-3.9). At least 1 sleep disorder was present in 42.9% of those with complete data on all assessments (n = 895).

Conclusions: Common sleep disorders are highly prevalent, to a clinically important extent, in an Australian community sample of middle-aged adults. Contemporary OSA prevalence is notably higher than previously reported and further work is needed to determine the communal impact of OSA.

Citation: McArdle N, Reynolds AC, Hillman D, et al. Prevalence of common sleep disorders in a middle-aged community sample. J Clin Sleep Med. 2022;18(6):1503-1514.

Keywords: community prevalence; insomnia; obstructive sleep apnea; restless legs syndrome.

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Conflict of interest statement

All authors have seen and approved the manuscript. The lead author (N.M.) affirms that the manuscript is an honest, accurate, and transparent account of the study being reported and that no important aspects of the study have been omitted. Work for this study was performed at University of Western Australia, School of Health Sciences, Nedlands, Australia. The Raine Study has been supported by the National Health and Medical Research Council (NHMRC) over the last 29 years with additional funding for core management provided by the University of Western Australia (UWA); Raine Medical Research Foundation; Telethon Kids Institute; UWA Faculty of Medicine, Dentistry and Health Sciences; Women and Infants Research Foundation; Curtin University; Edith Cowan University; Murdoch University; and the University of Notre Dame Australia. This year 26 follow‐up was made possible by the Raine Study team and sleep study technicians, The Centre for Sleep Science UWA, and Safework Australia, and supported by the National Health and Medical Research Council (ID 1021858, ID 1027449, ID 1044840, and ID 1084947). Peter Eastwood is supported by a NHMRC Senior Research Fellowship (1136548). N.M., P.E., D.H., and K.M. have received income to their institution for sponsored trials from Oventus Pty Ltd (Brisbane, Australia), Nyxoah Pty Ltd (Mont-Saint Guibert, Belgium), and Zelda (now Zelira) Therapeutics Pty Ltd (Australia). The other authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Study flow diagram.
PSG = polysomnography.
Figure 2
Figure 2. Prevalence and overlap of clinically significant sleep disorders in the subset of middle-aged adults with complete data on all sleep-related assessments (n = 895).
(A) Females. (B) Males. Each “person” represents a prevalence of 1%. Prevalence estimates are rounded to the nearest percent. Overlap between 2 disorders (ie, a person having multiple sleep disorders) is represented by a “person” shaded in the colors of each disorder. Clinically significant OSA was defined as OSA of any severity with excessive sleepiness (AHI ≥ 5 events/h and ESS ≥ 11) or AHI ≥ 15 events/h (even in the absence of symptoms), Clinically significant chronic insomnia was defined using the PSSQ-I, with modification of duration criteria from ≥ 4 weeks to ≥ 3 months. Clinically significant RLS was defined according to IRLSSG criteria when participants had symptoms 5 or more times per month involving moderate–severe distress. AHI = apnea-hypopnea index, ESS = Epworth Sleepiness Scale, IRLSSG = International Restless Legs Syndrome Study Group, OSA = obstructive sleep apnea, PSSQ-I = Pittsburgh Sleep Symptom Questionnaire–Insomnia, RLS = restless legs syndrome.
See this image and copyright information in PMC

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