Increased Prevalence of Sleep-Disordered Breathing in Adults

TLDR

Sleep‑disordered breathing is a common disorder with harmful sequelae, and obesity—an escalating epidemic—drives its prevalence, necessitating updated estimates. The study aimed to estimate US prevalence of moderate‑to‑severe sleep‑disordered breathing for 1988‑1994 and 2007‑2010 using data from the Wisconsin Sleep Cohort Study. Using 1,520 adults aged 30‑70 who underwent baseline polysomnography and periodic repeat studies, prevalence was modeled as a function of age, sex, and BMI and extrapolated to national BMI distributions from NHANES. Moderate‑to‑severe sleep‑disordered breathing prevalence is 10% in men 30‑49, 17% in men 50‑70, 3% in women 30‑49, and 9% in women 50‑70, representing 14–55% relative increases over the past two decades.

Abstract

Sleep-disordered breathing is a common disorder with a range of harmful sequelae. Obesity is a strong causal factor for sleep-disordered breathing, and because of the ongoing obesity epidemic, previous estimates of sleep-disordered breathing prevalence require updating. We estimated the prevalence of sleep-disordered breathing in the United States for the periods of 1988-1994 and 2007-2010 using data from the Wisconsin Sleep Cohort Study, an ongoing community-based study that was established in 1988 with participants randomly selected from an employed population of Wisconsin adults. A total of 1,520 participants who were 30-70 years of age had baseline polysomnography studies to assess the presence of sleep-disordered breathing. Participants were invited for repeat studies at 4-year intervals. The prevalence of sleep-disordered breathing was modeled as a function of age, sex, and body mass index, and estimates were extrapolated to US body mass index distributions estimated using data from the National Health and Nutrition Examination Survey. The current prevalence estimates of moderate to severe sleep-disordered breathing (apnea-hypopnea index, measured as events/hour, ≥15) are 10% (95% confidence interval (CI): 7, 12) among 30-49-year-old men; 17% (95% CI: 15, 21) among 50-70-year-old men; 3% (95% CI: 2, 4) among 30-49-year-old women; and 9% (95% CI: 7, 11) among 50-70 year-old women. These estimated prevalence rates represent substantial increases over the last 2 decades (relative increases of between 14% and 55% depending on the subgroup).