American Journal of Respiratory and Critical Care Medicine Vol 165. pp. 1217-1239, (2002)
© 2002 American Thoracic Society
Epidemiology of Obstructive Sleep Apnea
A Population Health Perspective
Terry Young,
Paul E. Peppard and
Daniel J. Gottlieb
Department of Population Health Sciences, University of WisconsinMadison, Madison, Wisconsin; and Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
Correspondence and requests for reprints should be addressed to Terry Young, Ph.D., Department of Population Health Sciences, University of WisconsinMadison, 502 N. Walnut Street, Madison, WI 53705. E-mail: tbyoung{at}facstaff.wisc.edu
Population-based epidemiologic studies have uncovered the high prevalence and wide severity spectrum of undiagnosed obstructive sleep apnea, and have consistently found that even mild obstructive sleep apnea is associated with significant morbidity. Evidence from methodologically strong cohort studies indicates that undiagnosed obstructive sleep apnea, with or without symptoms, is independently associated with increased likelihood of hypertension, cardiovascular disease, stroke, daytime sleepiness, motor vehicle accidents, and diminished quality of life. Strategies to decrease the high prevalence and associated morbidity of obstructive sleep apnea are critically needed. The reduction or elimination of risk factors through public health initiatives with clinical support holds promise. Potentially modifiable risk factors considered in this review include overweight and obesity, alcohol, smoking, nasal congestion, and estrogen depletion in menopause. Data suggest that obstructive sleep apnea is associated with all these factors, but at present the only intervention strategy supported with adequate evidence is weight loss. A focus on weight control is especially important given the expanding epidemic of overweight and obesity in the United States. Primary care providers will be central to clinical approaches for addressing the burden and the development of cost-effective case-finding strategies and feasible treatment for mild obstructive sleep apnea warrants high priority.
Key Words: obstructive sleep apnea sleep-disordered breathing epidemiology sleep disorder
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31(5):
1054 - 1060.
[Abstract]
[Full Text]
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P. Faure, R. Tamisier, J-P. Baguet, A. Favier, S. Halimi, P. Levy, and J-L. Pepin
Impairment of serum albumin antioxidant properties in obstructive sleep apnoea syndrome
Eur. Respir. J.,
May 1, 2008;
31(5):
1046 - 1053.
[Abstract]
[Full Text]
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S. Seicean, H. L. Kirchner, D. J. Gottlieb, N. M. Punjabi, H. Resnick, M. Sanders, R. Budhiraja, M. Singer, and S. Redline
Sleep-Disordered Breathing and Impaired Glucose Metabolism in Normal-Weight and Overweight/Obese Individuals: The Sleep Heart Health Study
Diabetes Care,
May 1, 2008;
31(5):
1001 - 1006.
[Abstract]
[Full Text]
[PDF]
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D. Sorajja, A. S. Gami, V. K. Somers, T. R. Behrenbeck, A. Garcia-Touchard, and F. Lopez-Jimenez
Independent Association Between Obstructive Sleep Apnea and Subclinical Coronary Artery Disease
Chest,
April 1, 2008;
133(4):
927 - 933.
[Abstract]
[Full Text]
[PDF]
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J-F Liang, J-L Fuh, H-Y Yu, C-Y Hsu, and S-J Wang
Clinical Features, Polysomnography and Outcome in Patients with Hypnic Headache
Cephalalgia,
March 1, 2008;
28(3):
209 - 215.
[Abstract]
[Full Text]
[PDF]
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D. J. Eckert and A. Malhotra
Pathophysiology of Adult Obstructive Sleep Apnea
Proceedings of the ATS,
February 15, 2008;
5(2):
144 - 153.
[Abstract]
[Full Text]
[PDF]
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W. T. McNicholas
Diagnosis of Obstructive Sleep Apnea in Adults
Proceedings of the ATS,
February 15, 2008;
5(2):
154 - 160.
[Abstract]
[Full Text]
[PDF]
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A. R. Schwartz, S. P. Patil, A. M. Laffan, V. Polotsky, H. Schneider, and P. L. Smith
Obesity and Obstructive Sleep Apnea: Pathogenic Mechanisms and Therapeutic Approaches
Proceedings of the ATS,
February 15, 2008;
5(2):
185 - 192.
[Abstract]
[Full Text]
[PDF]
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J. M. Golbin, V. K. Somers, and S. M. Caples
Obstructive Sleep Apnea, Cardiovascular Disease, and Pulmonary Hypertension
Proceedings of the ATS,
February 15, 2008;
5(2):
200 - 206.
[Abstract]
[Full Text]
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J. C. Lumeng and R. D. Chervin
Epidemiology of Pediatric Obstructive Sleep Apnea
Proceedings of the ATS,
February 15, 2008;
5(2):
242 - 252.
[Abstract]
[Full Text]
[PDF]
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E. Tasali, B. Mokhlesi, and E. Van Cauter
Obstructive Sleep Apnea and Type 2 Diabetes*: Interacting Epidemics
Chest,
February 1, 2008;
133(2):
496 - 506.
[Abstract]
[Full Text]
[PDF]
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J. B. Snow, V. Kitzis, C. E. Norton, S. N. Torres, K. D. Johnson, N. L. Kanagy, B. R. Walker, and T. C. Resta
Differential effects of chronic hypoxia and intermittent hypocapnic and eucapnic hypoxia on pulmonary vasoreactivity
J Appl Physiol,
January 1, 2008;
104(1):
110 - 118.
[Abstract]
[Full Text]
[PDF]
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C. Selmi, N. Montano, R. Furlan, C. L. Keen, and M. E. Gershwin
Inflammation and Oxidative Stress in Obstructive Sleep Apnea Syndrome
Exp Biol Med,
December 1, 2007;
232(11):
1409 - 1413.
[Abstract]
[Full Text]
[PDF]
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N. Kawata, K. Tatsumi, J. Terada, Y. Tada, N. Tanabe, Y. Takiguchi, and T. Kuriyama
Daytime Hypercapnia in Obstructive Sleep Apnea Syndrome
Chest,
December 1, 2007;
132(6):
1832 - 1838.
[Abstract]
[Full Text]
[PDF]
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C. F. P. George
Sleep Apnea, Alertness, and Motor Vehicle Crashes
Am. J. Respir. Crit. Care Med.,
November 15, 2007;
176(10):
954 - 956.
[Abstract]
[Full Text]
[PDF]
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N. P. Patel, M. Ahmed, and I. Rosen
Split-Night Polysomnography
Chest,
November 1, 2007;
132(5):
1664 - 1671.
[Abstract]
[Full Text]
[PDF]
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M. Ahmed, N. P. Patel, and I. Rosen
Portable Monitors in the Diagnosis of Obstructive Sleep Apnea
Chest,
November 1, 2007;
132(5):
1672 - 1677.
[Abstract]
[Full Text]
[PDF]
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E. J. Paavonen, S. Strang-Karlsson, K. Raikkonen, K. Heinonen, A.-K. Pesonen, P. Hovi, S. Andersson, A.-L. Jarvenpaa, J. G. Eriksson, and E. Kajantie
Very Low Birth Weight Increases Risk for Sleep-Disordered Breathing in Young Adulthood: The Helsinki Study of Very Low Birth Weight Adults
Pediatrics,
October 1, 2007;
120(4):
778 - 784.
[Abstract]
[Full Text]
[PDF]
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G. Parati, C. Lombardi, and K. Narkiewicz
Sleep apnea: epidemiology, pathophysiology, and relation to cardiovascular risk
Am J Physiol Regulatory Integrative Comp Physiol,
October 1, 2007;
293(4):
R1671 - R1683.
[Abstract]
[Full Text]
[PDF]
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M. L. Okun, M. Hall, and M. E. Coussons-Read
Sleep Disturbances Increase Interleukin-6 Production During Pregnancy: Implications for Pregnancy Complications
Reproductive Sciences,
September 1, 2007;
14(6):
560 - 567.
[Abstract]
[PDF]
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E. M. Friedman, G. D. Love, M. A. Rosenkranz, H. L. Urry, R. J. Davidson, B. H. Singer, and C. D. Ryff
Socioeconomic Status Predicts Objective and Subjective Sleep Quality in Aging Women
Psychosom Med,
September 1, 2007;
69(7):
682 - 691.
[Abstract]
[Full Text]
[PDF]
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M. A. Arias, A. M. Sanchez, A. Alonso-Fernandez, and F. Garcia-Rio
Atrial Fibrillation, Obesity, and Obstructive Sleep Apnea
Arch Intern Med,
July 23, 2007;
167(14):
1552 - 1553.
[Full Text]
[PDF]
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M. Alattar, J. J. Harrington, C. M. Mitchell, and P. Sloane
Sleep Problems in Primary Care: A North Carolina Family Practice Research Network (NC-FP-RN) Study
J Am Board Fam Med,
July 1, 2007;
20(4):
365 - 374.
[Abstract]
[Full Text]
[PDF]
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S. P. Patil, H. Schneider, A. R. Schwartz, and P. L. Smith
Adult Obstructive Sleep Apnea: Pathophysiology and Diagnosis
Chest,
July 1, 2007;
132(1):
325 - 337.
[Abstract]
[Full Text]
[PDF]
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R. D. Wells, K. E. Freedland, R. M. Carney, S. P. Duntley, and E. J. Stepanski
Adherence, Reports of Benefits, and Depression Among Patients Treated With Continuous Positive Airway Pressure
Psychosom Med,
June 1, 2007;
69(5):
449 - 454.
[Abstract]
[Full Text]
[PDF]
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P. M. de Paula, G. Tolstykh, and S. Mifflin
Chronic intermittent hypoxia alters NMDA and AMPA-evoked currents in NTS neurons receiving carotid body chemoreceptor inputs
Am J Physiol Regulatory Integrative Comp Physiol,
June 1, 2007;
292(6):
R2259 - R2265.
[Abstract]
[Full Text]
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L. F. Drager, L. A. Bortolotto, A. C. Figueiredo, B. C. Silva, E. M. Krieger, and G. Lorenzi-Filho
Obstructive Sleep Apnea, Hypertension, and Their Interaction on Arterial Stiffness and Heart Remodeling
Chest,
May 1, 2007;
131(5):
1379 - 1386.
[Abstract]
[Full Text]
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P. Haentjens, A. Van Meerhaeghe, A. Moscariello, S. De Weerdt, K. Poppe, A. Dupont, and B. Velkeniers
The Impact of Continuous Positive Airway Pressure on Blood Pressure in Patients With Obstructive Sleep Apnea Syndrome: Evidence From a Meta-analysis of Placebo-Controlled Randomized Trials
Arch Intern Med,
April 23, 2007;
167(8):
757 - 764.
[Abstract]
[Full Text]
[PDF]
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T. H. Le Jemtel and S. Jelic
Seek and Treat Obstructive Sleep Apnea in Heart Failure
J. Am. Coll. Cardiol.,
April 17, 2007;
49(15):
1632 - 1633.
[Full Text]
[PDF]
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S. Garrigue, J.-L. Pepin, P. Defaye, F. Murgatroyd, Y. Poezevara, J. Clementy, and P. Levy
High Prevalence of Sleep Apnea Syndrome in Patients With Long-Term Pacing: The European Multicenter Polysomnographic Study
Circulation,
April 3, 2007;
115(13):
1703 - 1709.
[Abstract]
[Full Text]
[PDF]
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H. Nakano, T. Tanigawa, T. Furukawa, and S. Nishima
Automatic detection of sleep-disordered breathing from a single-channel airflow record
Eur. Respir. J.,
April 1, 2007;
29(4):
728 - 736.
[Abstract]
[Full Text]
[PDF]
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S. Ryan, S. Ward, C. Heneghan, and W. T. McNicholas
Predictors of Decreased Spontaneous Baroreflex Sensitivity in Obstructive Sleep Apnea Syndrome
Chest,
April 1, 2007;
131(4):
1100 - 1107.
[Abstract]
[Full Text]
[PDF]
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G. E. Foster, P. J. Hanly, M. Ostrowski, and M. J. Poulin
Effects of Continuous Positive Airway Pressure on Cerebral Vascular Response to Hypoxia in Patients with Obstructive Sleep Apnea
Am. J. Respir. Crit. Care Med.,
April 1, 2007;
175(7):
720 - 725.
[Abstract]
[Full Text]
[PDF]
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B. Lam, K. Sam, W. Y. Mok, M. T. Cheung, D. Y. Fong, J. C. Lam, D. C. Lam, L. Y. Yam, and M. S. lp
Randomised study of three non-surgical treatments in mild to moderate obstructive sleep apnoea
Thorax,
April 1, 2007;
62(4):
354 - 359.
[Abstract]
[Full Text]
[PDF]
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Copyright © 2002 American Thoracic Society
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