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Sleep-Disordered Breathing Largely Undiagnosed
Archives of Internal Medicine
04/22/2002
By Elda Hauschildt
Sleep-disordered breathing (SDB) will remain largely undiagnosed if screening or testing is restricted to men, the middle-aged or people who are obese.
Researchers also say that snoring and obesity may actually not be sensitive factors for identifying SDB in older people.
Investigators with the United States Sleep Heart Health Study (SHHS) research group evaluated the association of sex, age, race, snoring and obesity with SDB in 5,615 community-dwelling adults. Participants were all aged 40 to 98 years and enrolled in the SHHS, a multicentre cohort study of SDB and cardiovascular disease.
"We found that the demographic pattern of SDB includes a moderately higher risk for men compared with women and a small increase in risk with age," say researchers led by Dr. Terry Young of the University of Wisconsin-Madison, United States. "Additional significant predictors of SDB included increased measures of body habitus and self-reported habitual snoring, very loud snoring and frequent self-reported breathing pauses.
"We also found that some of the associations of these predictors and SDB varied by demographic characteristics."
Investigators collected data by questionnaire, clinical examination and in-home polysomnography. SDB status was based on the apnoea-hypopnea index (AHI), the average number of apnoea and hypopnea episodes participants had per hour of sleep. SDB was defined by an AHI of 15 or greater.
Male sex, age, body mass index, neck girth, snoring and repeated breathing pause frequency are independent, significant correlates of an AHI of 15 or greater, the researchers reported. People who report habitual and loud snoring and frequent breathing pauses are three to four times more likely to have an AHI of 15 or greater. "As age increased, the magnitude of associations for SDB and body habitus, snoring and breathing pauses decreased," they note.
The lack of marked increase in SDB prevalence in older age suggests the role of late-life aging in SDB needs to be investigated. Case finding should not be restricted to men, the middle-aged or obese people, they add.
Archives of Internal Medicine, 2002; 162: 893-900.
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