Prevalence of sleep-disordered breathing in ages 40-64 years: a population-based survey

Abstract

Previous research has offered widely varying prevalence estimates for sleep apnea in the population, leaving uncertain which breathing patterns are abnormal. To explore the distribution of sleep apnea in the population and its co-morbidities, random telephone dialing was used between 1990 and 1994 to recruit subjects for a prevalence survey of sleep-disordered breathing in San Diego adults. Events from which blood oxygen desaturations > or = 4% resulted were monitored with home recording instruments, usually for three consecutive nights. Among 190 women ages 40-64 years, a median of 4.3 desaturation events per hour of sleep were observed. A higher median of 6.7 events per hour was observed among 165 men. Frequencies were much higher among members of minority groups, leading to a standard estimate that 16.3% of U.S. Hispanics and racial minorities have > or = 20 events/hour as compared to 4.9% of non-Hispanic Whites ages 40-64. Obesity indicated by body-mass index was the most important demographic predictor of sleep-disordered breathing, followed by age, male gender, and ethnicity. Quality of well-being was not significantly impaired in subjects with more respiratory events; however, there was some increase in blood pressure and wake-within-sleep associated with sleep-disordered breathing. This survey indicates that sleep-disordered breathing is more common, especially among minorities, than had been previously believed, but less co-morbidity may be associated.

FIG. 1

The solid and dotted lines show the percentages (left axis) of men and women with ODI4 greater or equal to each level on the abscissa. The histogram bars show the percentages (right axis) of males and females in each ODI4 range. The abscissa ranges are spaced logarithmically. ODI4 is ≥4% oxygen-desaturation events per hour of sleep.

FIG. 2

Percentages of subjects with ODI4 < 20 or ≥20 are shown by obesity, gender, age, and ethnicity, grouping non-Hispanic Whites, Hispanics, Blacks, and all other minorities (mostly Asians).

FIG. 3

Adjusted quality of well-being scale (QWB) scores are plotted for subjects with five levels of ODI4. The group with ODI4 ≥20 includes subjects with ODI4 from 20 to 128. Although the theoretical range of QWB-scale scores is 0–100, adjustment for age, gender, BMI, and ethnicity produced one slightly higher adjusted score

FIG. 4

Adjusted systolic blood pressures are plotted for five levels of ODI4. The group with ODI4 ≥20 includes subjects with ODI4 from 20 to 128. Blood pressures were adjusted for age, gender, BMI, and ethnicity.