Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study.
- Heinzer R Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland; Pulmonary Department, University Hospital of Lausanne, Lausanne, Switzerland. Electronic address: raphael.heinzer@chuv.ch.
- Vat S Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland; Pulmonary Medicine Department, University Hospital of Montreal, Montreal, QC, Canada.
- Marques-Vidal P Department of Internal Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
- Marti-Soler H Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland.
- Andries D Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland.
- Tobback N Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland.
- Mooser V Laboratory Department, University Hospital of Lausanne, Lausanne, Switzerland.
- Preisig M Psychiatry Department, University Hospital of Lausanne, Lausanne, Switzerland.
- Malhotra A University of Southern California San Diego, Division of Pulmonary and Critical Care, La Jolla, CA, USA.
- Waeber G Department of Internal Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
- Vollenweider P Department of Internal Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
- Tafti M Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland; Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland.
- Haba-Rubio J Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland.
- 2015-02-16
Published in:
- The Lancet. Respiratory medicine. - 2015
Adult
Age Distribution
Aged
Aged, 80 and over
Alcohol Drinking
Body Mass Index
Depression
Diabetes Mellitus
Female
Humans
Hypertension
Logistic Models
Male
Metabolic Syndrome
Middle Aged
Odds Ratio
Overweight
Polysomnography
Prevalence
Risk Factors
Severity of Illness Index
Sleep Apnea Syndromes
Sleep Apnea, Central
Sleep Apnea, Obstructive
Smoking
Switzerland
English
BACKGROUND
Sleep-disordered breathing is associated with major morbidity and mortality. However, its prevalence has mainly been selectively studied in populations at risk for sleep-disordered breathing or cardiovascular diseases. Taking into account improvements in recording techniques and new criteria used to define respiratory events, we aimed to assess the prevalence of sleep-disordered breathing and associated clinical features in a large population-based sample.
METHODS
Between Sept 1, 2009, and June 30, 2013, we did a population-based study (HypnoLaus) in Lausanne, Switzerland. We invited a cohort of 3043 consecutive participants of the CoLaus/PsyCoLaus study to take part. Polysomnography data from 2121 people were included in the final analysis. 1024 (48%) participants were men, with a median age of 57 years (IQR 49-68, range 40-85) and mean body-mass index (BMI) of 25·6 kg/m(2) (SD 4·1). Participants underwent complete polysomnographic recordings at home and had extensive phenotyping for diabetes, hypertension, metabolic syndrome, and depression. The primary outcome was prevalence of sleep-disordered breathing, assessed by the apnoea-hypopnoea index.
FINDINGS
The median apnoea-hypopnoea index was 6·9 events per h (IQR 2·7-14·1) in women and 14·9 per h (7·2-27·1) in men. The prevalence of moderate-to-severe sleep-disordered breathing (≥15 events per h) was 23·4% (95% CI 20·9-26·0) in women and 49·7% (46·6-52·8) in men. After multivariable adjustment, the upper quartile for the apnoea-hypopnoea index (>20·6 events per h) was associated independently with the presence of hypertension (odds ratio 1·60, 95% CI 1·14-2·26; p=0·0292 for trend across severity quartiles), diabetes (2·00, 1·05-3·99; p=0·0467), metabolic syndrome (2·80, 1·86-4·29; p<0·0001), and depression (1·92, 1·01-3·64; p=0·0292).
INTERPRETATION
The high prevalence of sleep-disordered breathing recorded in our population-based sample might be attributable to the increased sensitivity of current recording techniques and scoring criteria. These results suggest that sleep-disordered breathing is highly prevalent, with important public health outcomes, and that the definition of the disorder should be revised.
FUNDING
Faculty of Biology and Medicine of Lausanne, Lausanne University Hospital, Swiss National Science Foundation, Leenaards Foundation, GlaxoSmithKline, Ligue Pulmonaire Vaudoise.
Sleep-disordered breathing is associated with major morbidity and mortality. However, its prevalence has mainly been selectively studied in populations at risk for sleep-disordered breathing or cardiovascular diseases. Taking into account improvements in recording techniques and new criteria used to define respiratory events, we aimed to assess the prevalence of sleep-disordered breathing and associated clinical features in a large population-based sample.
METHODS
Between Sept 1, 2009, and June 30, 2013, we did a population-based study (HypnoLaus) in Lausanne, Switzerland. We invited a cohort of 3043 consecutive participants of the CoLaus/PsyCoLaus study to take part. Polysomnography data from 2121 people were included in the final analysis. 1024 (48%) participants were men, with a median age of 57 years (IQR 49-68, range 40-85) and mean body-mass index (BMI) of 25·6 kg/m(2) (SD 4·1). Participants underwent complete polysomnographic recordings at home and had extensive phenotyping for diabetes, hypertension, metabolic syndrome, and depression. The primary outcome was prevalence of sleep-disordered breathing, assessed by the apnoea-hypopnoea index.
FINDINGS
The median apnoea-hypopnoea index was 6·9 events per h (IQR 2·7-14·1) in women and 14·9 per h (7·2-27·1) in men. The prevalence of moderate-to-severe sleep-disordered breathing (≥15 events per h) was 23·4% (95% CI 20·9-26·0) in women and 49·7% (46·6-52·8) in men. After multivariable adjustment, the upper quartile for the apnoea-hypopnoea index (>20·6 events per h) was associated independently with the presence of hypertension (odds ratio 1·60, 95% CI 1·14-2·26; p=0·0292 for trend across severity quartiles), diabetes (2·00, 1·05-3·99; p=0·0467), metabolic syndrome (2·80, 1·86-4·29; p<0·0001), and depression (1·92, 1·01-3·64; p=0·0292).
INTERPRETATION
The high prevalence of sleep-disordered breathing recorded in our population-based sample might be attributable to the increased sensitivity of current recording techniques and scoring criteria. These results suggest that sleep-disordered breathing is highly prevalent, with important public health outcomes, and that the definition of the disorder should be revised.
FUNDING
Faculty of Biology and Medicine of Lausanne, Lausanne University Hospital, Swiss National Science Foundation, Leenaards Foundation, GlaxoSmithKline, Ligue Pulmonaire Vaudoise.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1016/S2213-2600(15)00043-0
- PMID 25682233
- Persistent URL
- https://folia.unifr.ch/unifr/documents/281358
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