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Sleep Apnea
Last edited |
10/22/2008
Written by Maurice M. Ohayon, MD, DSc, PhD
Few surveys have estimated the
prevalence of sleep apnea or obstructive sleep apnea syndrome in
community-based samples
Target population, methods, and criteria considerably varied between
studies.
In all cases, prevalences are estimation because it is virtually impossible
to perform polysomnographic recordings on all participants.
Therefore screening questionnaires were used to identify participants most
likely to have sleep apnea or obstructive sleep apnea syndrome.
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The Israeli study by Lavie (72) was one of the first to
explore obstructive sleep apnea in a non-clinical sample.
Here, 300 working men were examined, 78 of which with polysomnography.
An apnea/hypopnea index (AHI) greater than or equal to 10 was found in
2.7% of the sample and an AHI greater than or equal to 20 in 0.7%.
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In the Finnish twin cohort study, Telakivi et al. (139)
carried out polysomnographic recordings on 25 snorers and 27 non-snorers
selected from among 278 men aged 41 to 50 years.
They estimated that 0.4% of this population had an AHI greater than or
equal to 20 and that 1.4% had an AHI greater than or equal to 10, with
an oxygenation desaturation index (ODI) of at least 4%.
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In Sweden, Gislason et al. (38) assessed 3,201 men aged
30 to 60 years and conducted polysomnographic recordings on 61 sleepy
snorers.
They calculated that 0.9% of this population had an AHI greater than or
equal to 10 and that 1.4% had an AHI greater than or equal to 20.
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In a similar survey involving 1,505 Icelandic women 40 to
59 years old, Gislason et al. (40) found that 2.5% of the sample
presented with a sleep apnea syndrome defined as daytime sleepiness with
an AHI ≥30.
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In Italy, Cirignotta et al. (25) surveyed 1,510 men aged
30 to 69 years via a postal questionnaire and selected 156 of them for
polysomnography.
They estimated that 4.8% of this population had an AHI greater than 5,
and 3.2% an AHI greater than 10.
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In Spain, Duran et al (30) interviewed 2148 individuals
from the general population and performed polysomography with 555 of
them.
The prevalence of AHI>=10 was at 19% among men and 14.9% among women.
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The Wisconsin Sleep Cohort study (154) looked at 3,513
workers aged 30 to 60 years.
Of these, 625 habitual and non-habitual snorers were submitted to a
one-night polysomnographic recording.
For women, 18.9% of habitual snorers and 5% of non-habitual snorers had
an AHI of 5 or greater.
For men, the corresponding figures were 34% and 16.1%, respectively.
Based on these findings, the prevalence of sleep apnea syndrome (daytime
sleepiness and/or non-refreshing sleep and an AHI of 5 or greater) was
estimated at 4% among men and 2% among women.
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Two studies performed using large community based samples
(15,17) screened for possible sleep breathing disorders and recorded
1741 participants.
The prevalence of sleep apnea, defined as AHI >=10 accompanied with
daytime symptoms was estimated at 3.3% among men (17) and 1.2% among
women (15).
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In Australia, the Busselton health survey (11) found that
12.2% of men aged 40 to 65 years had at least five respiratory
disturbances per hour of sleep (RDI ≥5) along with at least occasional
daytime sleepiness, and that 3.1% had an RDI greater than or equal to 5
along with daytime sleepiness at least often.
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Also in Australia, Olson et al. (114) queried 2,202
subjects aged 35 to 69 years and monitored 441 of these who complained
about their sleep or snored.
The rate of obstructive sleep apnea syndrome, based on an AHI of 15 or
greater, was estimated at 3.6% overall, and at 5.7% for men and 1.2% for
women.
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In Hong Kong, Ip et al (57) screened 1532 women between
30 and 60 years and performed polysomnography on 106 of them.
They reported a prevalence of AHI>= 5 at 3.7%; an AHI>= 5 accompanied
with daytime sleepiness was found in 2.1% of their sample.
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Using a similar methodology, Udwadia et al (141) screened
658 Indian men aged between 35 and 65 and performed polysomnography on
250 of them.
They reported a prevalence of AHI>= 5 at 19.5%; an AHI>= 5 accompanied
with daytime sleepiness was found in 7.5% of their sample.
Prevalence of sleep apnea in
selected samples
|
Authors |
Population |
N (n recorded) |
Age |
Methods |
Criteria |
Prevalence (%) |
|
Lavie (72)
Israel, 1983 |
Male workers |
1502 (78) |
32-67 |
1) Questionnaire
2) Polysomnography |
AI ≥ 10 |
0.89 |
|
Gislason et al (38)
Uppsala , Sweden, 1988 |
Men, general population |
3201 (61) |
30-69 |
1) Postal questionnaire
2) Polysomnography,
sleepy snorers |
AHI ≥ 30 + daytime
sleepiness |
1.3 |
|
Cirignotta et al. (25)
Bologna, Italy, 1989 |
Men, general population |
1170 (40) |
30-69 |
1) Postal questionnaire
2) Polysomnography,
every-night snorers |
AHI ≥ 10 |
2.7 |
|
Martikainen et al. (84)
Tempere, Finland, 1994 |
General population |
1985: 1190
1990: 626 (22) |
36-50 |
1) Postal questionnaire
2) Polysomnography,
habitual male snorers |
ODI ≥ 4% > 5 per hour
ODI ≥ 4% > 10 per hour |
1.8
1.1 |
|
Ancoli-Israel et al. (2)
San Diego,USA, 1991 |
General population |
615 (427) |
65-95 |
Home Polysomnography |
AI ≥ 5
RDI ≥ 10 |
24.0
62.0 |
|
Stradling & Cosby (136)
Oxford, UK, 1991 |
Men, age-sex register of
one group general practice |
1001 (893) |
35-65 |
Oximetry |
ODI ≥ 4% > 5 per hour
ODI ≥ 4% > 10 per hour
ODI ≥ 3% > 10 per hour +
symptoms |
5.0
1.0
0.8 |
|
Gislason et al. (40)
Reykjavik, Iceland, 1993 |
Women, general
population |
1505 (35) |
40-59 |
1) Postal questionnaire
2) Polysomnography,
sleepy snorers |
AHI ≥ 30 + daytime
sleepiness |
2.5 |
|
Young et al. (154)
USA, 1993 |
State employees |
3513 (625) |
30-60 |
1) Questionnaire
2) Polysomnography,
snorers |
AHI ≥ 5 + daytime
sleepiness or non-refreshing sleep |
4.0 (M)
2.0 (W) |
|
Olson et al (114)
Australia, 1995 |
General population |
2202 (441) |
35-69 |
1) Questionnaire
2) repiratory measurment,
overrepresentation of snorers and sleep complainers |
AHI ≥ 10 |
5.7 (M)
1.2 (W) |
|
Bearpark et al. [(11)
Busselton, Australia,
1995 |
Men, general population |
486 (294) |
40-65
|
1) Questionnaire
2) Polysomnography |
RDI ≥ 5 + at least
occasional daytime sleepiness
RDI ≥ 5 + at least often
daytime sleepiness |
12.2
3.1 |
|
Bixler et al. (17)
Pennsylvania, USA, 1998 |
Men, general population |
4364 (741) |
20-100 |
1) Telephone interview
2) Polysomnography |
AHI ≥ 10 + daytime
symptoms |
3.3 |
|
Bixler et al. (15)
Pennsylvania, USA, 2001 |
Women, general
population |
12,219 (1000) |
20-100 |
1) Telephone interview
2) Polysomnography |
AHI ≥ 10 + daytime
symptoms |
1.2 |
|
Duran et al. (30)
Vitoria-Gasteiz, Spain, 2001
|
Men and women, general
population |
2148 (555) |
30-70 |
1) Home interview
2) Portable respiratory
recording
3) Polysomnography |
AHI ≥ 10 |
19.0 (M)
14.9 (W) |
|
Ip et al. (57)
Hong Kong, 2004 |
Women, general
population |
1532 (106) |
30-60 |
1) Questionnaire
2) Polysomnography |
AHI ≥ 5
AHI ≥ 5 + excessive
daytime sleepiness |
3.7
2.1 |
|
Udwadia
et al. (141)
Bombay, India, 2004 |
Men, general population |
658 (250) |
35-65 |
1) Questionnaire
2) Polysomnography |
AHI ≥ 5
AHI ≥ 5 + excessive
daytime sleepiness |
19.5
7.5 |
AI= Apnea index; AHI= Apnea/hypopnea index; ODI=Oxygen desaturation index;
RDI=Respiratory disturbance index
Content of this page
is extracted from
Ohayon MM.
Epidemiology of sleep disorders in the general population.
Guilleminault C (ed) Sleep and its disorders. Series Handbook of Clinical
Neurophysiology, 2005.
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