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Epidemiology of Obstructive Sleep Apnea

A Population Health Perspective

Department of Population Health Sciences, University of Wisconsin—Madison, 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 Wisconsin—Madison, 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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				A. Tarasiuk, S. Greenberg-Dotan, T. Simon, A. Tal, A. Oksenberg, and H. Reuveni Low socioeconomic status is a risk factor for cardiovascular disease among adult obstructive sleep apnea syndrome patients requiring treatment. Chest, September 1, 2006; 130(3): 766 - 773. [Abstract] [Full Text] [PDF]

				D. M. Hiestand, P. Britz, M. Goldman, and B. Phillips Prevalence of Symptoms and Risk of Sleep Apnea in the US Population: Results From the National Sleep Foundation Sleep in America 2005 Poll. Chest, September 1, 2006; 130(3): 780 - 786. [Abstract] [Full Text] [PDF]

				M. W. Nicolle, S. Rask, W. J. Koopman, C.F.P. George, J. Adams, and S. Wiebe Sleep apnea in patients with myasthenia gravis. Neurology, July 11, 2006; 67(1): 140 - 142. [Abstract] [Full Text] [PDF]

				L. C. Johnson, T. L. Richards, K. H. Archbold, and C. A. Landis Functional magnetic resonance imaging in nursing research. Biol Res Nurs, July 1, 2006; 8(1): 43 - 54. [Abstract] [PDF]

				A. D. Goldbart, J. Krishna, R. C. Li, L. D. Serpero, and D. Gozal Inflammatory Mediators in Exhaled Breath Condensate of Children With Obstructive Sleep Apnea Syndrome. Chest, July 1, 2006; 130(1): 143 - 148. [Abstract] [Full Text] [PDF]

				B. Najem, A. Houssiere, A. Pathak, C. Janssen, D. Lemogoum, O. Xhaet, N. Cuylits, and P. van de Borne Acute Cardiovascular and Sympathetic Effects of Nicotine Replacement Therapy Hypertension, June 1, 2006; 47(6): 1162 - 1167. [Abstract] [Full Text] [PDF]

				S. Ferreira, J. Winck, P. Bettencourt, and F. Rocha-Goncalves Heart failure and sleep apnoea: To sleep perchance to dream Eur J Heart Fail, May 1, 2006; 8(3): 227 - 236. [Abstract] [Full Text] [PDF]

				N S Marshall, M Barnes, N Travier, A J Campbell, R J Pierce, R D McEvoy, A M Neill, and P H Gander Continuous positive airway pressure reduces daytime sleepiness in mild to moderate obstructive sleep apnoea: a meta-analysis Thorax, May 1, 2006; 61(5): 430 - 434. [Abstract] [Full Text] [PDF]

				M. A. Arias, A. Alonso-Fernandez, F. Garcia-Rio, G. Hu, P. Jousilahti, and J. Tuomilehto Obstructive Sleep Apnea as an Independent Risk Factor for Stroke and Mortality Stroke, May 1, 2006; 37(5): 1150 - 1150. [Full Text] [PDF]

				F. H. Sert Kuniyoshi and V. K. Somers Sleep Apnea in Hypertension: When, How, and Why Should We Treat? Hypertension, May 1, 2006; 47(5): 818 - 819. [Full Text] [PDF]

				R. J. Schwab, M. Pasirstein, L. Kaplan, R. Pierson, A. Mackley, R. Hachadoorian, R. Arens, G. Maislin, and A. I. Pack Family Aggregation of Upper Airway Soft Tissue Structures in Normal Subjects and Patients with Sleep Apnea Am. J. Respir. Crit. Care Med., February 15, 2006; 173(4): 453 - 463. [Abstract] [Full Text] [PDF]