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Terry Young - One of the best experts on this subject based on the ideXlab platform.
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increased prevalence of Sleep Disordered Breathing in adults
American Journal of Epidemiology, 2013Co-Authors: Paul E Peppard, Terry Young, Mari Palta, Jodi H Barnet, Erika W Hagen, Khin Mae HlaAbstract:Sleep-Disordered Breathing is a common disorder with a range of harmful sequelae. Obesity is a strong causal factor for Sleep-Disordered Breathing, and because of the ongoing obesity epidemic, previous estimates of Sleep-Disordered Breathing prevalence require updating. We estimated the prevalence of Sleep-Disordered Breathing in the United States for the periods of 1988–1994 and 2007–2010 using data from the Wisconsin Sleep Cohort Study, an ongoing community-based study that was established in 1988 with participants randomly selected from an employed population of Wisconsin adults. A total of 1,520 participants who were 30–70 years of age had baseline polysomnography studies to assess the presence of Sleep-Disordered Breathing. Participants were invited for repeat studies at 4-year intervals. The prevalence of Sleep-Disordered Breathing was modeled as a function of age, sex, and body mass index, and estimates were extrapolated to US body mass index distributions estimated using data from the National Health and Nutrition Examination Survey. The current prevalence estimates of moderate to severe Sleep-Disordered Breathing (apnea-hypopnea index, measured as events/hour, ≥15) are 10% (95% confidence interval (CI): 7, 12) among 30–49-year-old men; 17% (95% CI: 15, 21) among 50–70-year-old men; 3% (95% CI: 2, 4) among 30–49-year-old women; and 9% (95% CI: 7, 11) among 50–70 year-old women. These estimated prevalence rates represent substantial increases over the last 2 decades (relative increases of between 14% and 55% depending on the subgroup).
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association of Sleep Disordered Breathing and the occurrence of stroke
American Journal of Respiratory and Critical Care Medicine, 2005Co-Authors: Michael Arzt, Terry Young, Laurel Finn, James B. Skatrud, Douglas T BradleyAbstract:Rationale: Sleep-Disordered Breathing has been linked to stroke in previous studies. However, these studies either used surrogate markers of Sleep-Disordered Breathing or could not, due to cross-sectional design, address the temporal relationship between Sleep-Disordered Breathing and stroke. Objectives: To determine whether Sleep-Disordered Breathing increases the risk for stroke. Methods: We performed cross-sectional and longitudinal analyses on 1,475 and 1,189 subjects, respectively, from the general population. Sleep-Disordered Breathing was defined by the apnea–hypopnea index (frequency of apneas and hypopneas per hour of Sleep) obtained by attended polysomnography. The protocol, including polysomnography, risk factors for stroke, and a history of physician-diagnosed stroke, was repeated at 4-yr intervals. Measurements and Main Results: In the cross-sectional analysis, subjects with an apnea–hypopnea index of 20 or greater had increased odds for stroke (odds ratio, 4.33; 95% confidence interval, 1.32–14.24; p = 0.02) compared with those without Sleep-Disordered Breathing (apnea–hypopnea index, <5) after adjustment for known confounding factors. In the prospective analysis, Sleep-Disordered Breathing with an apnea–hypopnea index of 20 or greater was associated with an increased risk of suffering a first-ever stroke over the next 4 yr (unadjusted odds ratio, 4.31; 95% confidence interval, 1.31–14.15; p = 0.02). However, after adjustment for age, sex, and body mass index, the odds ratio was still elevated, but was no longer significant (3.08; 95% confidence interval, 0.74–12.81; p = 0.12). Conclusions: These data demonstrate a strong association between moderate to severe Sleep-Disordered Breathing and prevalent stroke, independent of confounding factors. They also provide the first prospective evidence that Sleep-Disordered Breathing precedes stroke and may contribute to the development of stroke.
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excess weight and Sleep Disordered Breathing
Journal of Applied Physiology, 2005Co-Authors: Terry Young, Paul E Peppard, Shahrad TaheriAbstract:Excess weight is a well-established predictor of Sleep-Disordered Breathing (SDB). Clinical observations and population studies throughout the United States, Europe, Asia, and Australia have consis...
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Association of Sleep-Disordered Breathing and the occurrence of stroke.
American Journal of Respiratory and Critical Care Medicine, 2005Co-Authors: Michael Arzt, Terry Young, Laurel Finn, James B. Skatrud, T. Douglas BradleyAbstract:Rationale: Sleep-Disordered Breathing has been linked to stroke in previous studies. However, these studies either used surrogate markers of Sleep-Disordered Breathing or could not, due to cross-sectional design, address the temporal relationship between Sleep-Disordered Breathing and stroke. Objectives: To determine whether Sleep-Disordered Breathing increases the risk for stroke. Methods: We performed cross-sectional and longitudinal analyses on 1,475 and 1,189 subjects, respectively, from the general population. Sleep-Disordered Breathing was defined by the apnea–hypopnea index (frequency of apneas and hypopneas per hour of Sleep) obtained by attended polysomnography. The protocol, including polysomnography, risk factors for stroke, and a history of physician-diagnosed stroke, was repeated at 4-yr intervals. Measurements and Main Results: In the cross-sectional analysis, subjects with an apnea–hypopnea index of 20 or greater had increased odds for stroke (odds ratio, 4.33; 95% confidence interval, 1.32–14.24; p = 0.02) compared with those without Sleep-Disordered Breathing (apnea–hypopnea index,
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Prospective study of the association between Sleep-Disordered Breathing and hypertension.
New England Journal of Medicine, 2000Co-Authors: Paul E Peppard, Terry Young, Mari Palta, James B. SkatrudAbstract:CREENING studies in the United States, Europe, and Australia have shown that a substantial proportion of the adult population has mild-to-moderate Sleep-Disordered Breathing, a condition characterized by repeated episodes of apnea and hypopnea during Sleep. 1-6 Apnea and hypopnea cause temporary elevations in blood pressure in association with blood oxygen desaturation, arousal, and sympathetic activation and may cause elevated blood pressure during the daytime and, ultimately, sustained hypertension. 7 Recent reviews judged the epidemiologic evidence relating Sleep-Disordered Breathing to hypertension to be inconclusive, but they noted that study designs were inappropriate, that there was inadequate control for confounding factors such as obesity, and that there was a dearth of prospective studies. 8,9 Since Sleep-Disordered Breathing is prevalent and treatable and the morbidity and costs of hypertension are profound, a rigorous assessment of the relation between the two conditions remains a priority. We assessed the association between Sleep-Disordered Breathing and hypertension in a prospective analysis of data from the Wisconsin Sleep Cohort Study. The Sleep Cohort Study is a population-based, longitudinal study of the natural history of Sleep-Disordered Breathing in adults. Participants complete overnight Sleep studies at four-year intervals. These studies include assessment of Sleep-Disordered Breathing (by monitored polysomnography), blood pressure, and many potential confounding factors.
Robert N. Glidewell - One of the best experts on this subject based on the ideXlab platform.
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Comorbid Insomnia and Sleep Disordered Breathing
Current Treatment Options in Neurology, 2013Co-Authors: Robert N. GlidewellAbstract:Opinion statementSufficient evidence has accumulated to warrant conceptualization of comorbid insomnia and Sleep Disordered Breathing (SDB) as a distinct clinical syndrome. As such, diagnostic and treatment approaches should be founded on an integrated and multidisciplinary approach with equivalent clinical attention and priority given to both insomnia and respiratory aspects of patients’ presenting complaints. Several well established and effective treatments exist for both insomnia and SDB. Although questions of optimal treatment combination and sequence remain to be examined, current evidence provides preliminary guidance regarding the sequential or concurrent management of insomnia and Sleep Disordered Breathing when comorbid. Unsatisfactory response to pharmacotherapy or cognitive-behavioral therapy for chronic insomnia should trigger evaluation for comorbid Sleep-related Breathing disturbance prior to more aggressive or off label pharmacotherapy. Presence and course of insomnia symptoms should be monitored closely in SDB patients with persistence of insomnia symptoms following SDB treatment prompting targeted treatment of insomnia. Aggressive treatment of insomnia prior to or in combination with SDB treatment may be particularly indicated in situations where insomnia is suspected to interfere with diagnosis or treatment of SDB. Insomnia and Sleep Disordered Breathing appear to uniquely contribute to the morbidity of patients with this comorbidity. With this in mind, active engagement and monitoring of SDB and insomnia will often be necessary to achieve optimal outcomes.
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Comorbid Insomnia and Sleep Disordered Breathing
Current Treatment Options in Neurology, 2013Co-Authors: Robert N. GlidewellAbstract:Sufficient evidence has accumulated to warrant conceptualization of comorbid insomnia and Sleep Disordered Breathing (SDB) as a distinct clinical syndrome. As such, diagnostic and treatment approaches should be founded on an integrated and multidisciplinary approach with equivalent clinical attention and priority given to both insomnia and respiratory aspects of patients’ presenting complaints. Several well established and effective treatments exist for both insomnia and SDB. Although questions of optimal treatment combination and sequence remain to be examined, current evidence provides preliminary guidance regarding the sequential or concurrent management of insomnia and Sleep Disordered Breathing when comorbid. Unsatisfactory response to pharmacotherapy or cognitive-behavioral therapy for chronic insomnia should trigger evaluation for comorbid Sleep-related Breathing disturbance prior to more aggressive or off label pharmacotherapy. Presence and course of insomnia symptoms should be monitored closely in SDB patients with persistence of insomnia symptoms following SDB treatment prompting targeted treatment of insomnia. Aggressive treatment of insomnia prior to or in combination with SDB treatment may be particularly indicated in situations where insomnia is suspected to interfere with diagnosis or treatment of SDB. Insomnia and Sleep Disordered Breathing appear to uniquely contribute to the morbidity of patients with this comorbidity. With this in mind, active engagement and monitoring of SDB and insomnia will often be necessary to achieve optimal outcomes.
Tapani Salmi - One of the best experts on this subject based on the ideXlab platform.
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Esophageal pressure monitoring in detection of Sleep-Disordered Breathing.
The Laryngoscope, 2002Co-Authors: Paula Virkkula, Juha Silvola, Paula Maasilta, Henrik Malmberg, Tapani SalmiAbstract:The aim was to study the value of esophageal pressure monitoring combined with limited polygraphic recording (oxygen saturation, respiratory and leg movements, airflow, body position, and snoring sound) in diagnosis of Sleep-Disordered Breathing. A prospective study of consecutive patients with snoring was carried out. Sixty-seven patients underwent an overnight study on ward. Patients with normal oxygen desaturation index and any periodic Breathing disturbances combined with elevated esophageal pressure were further studied with complete polysomnography. The patient compliance with esophageal catheter was 87%. Esophageal pressure monitoring increased effectively the detection of Sleep-Disordered Breathing with limited polygraphic recording. Sixty-seven percent of the patients with normal oxygen desaturation index and respiratory-related esophageal pressure variation had Sleep-Disordered Breathing on complete polysomnography. Increased esophageal pressure variation was significantly related with oxygen desaturation index and obstructive Sleep apnea diagnosis (P <.001). All together, 48% of the mainly nonobese snorers had objective findings of Sleep-Disordered Breathing. Patients with upper airway resistance syndrome were few. Fifteen percent of the patients had periodic leg movements. Neither subjective or objective Sleepiness nor snoring or obesity adequately exposed Sleep-Disordered Breathing in this material. Esophageal pressure monitoring increases markedly the diagnostic value of limited polygraphic recording as a screening study for Sleep-Disordered Breathing.
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Esophageal pressure monitoring in detection of Sleep-Disordered Breathing.
The Laryngoscope, 2002Co-Authors: Paula Virkkula, Juha Silvola, Paula Maasilta, Henrik Malmberg, Tapani SalmiAbstract:Objective The aim was to study the value of esophageal pressure monitoring combined with limited polygraphic recording (oxygen saturation, respiratory and leg movements, airflow, body position, and snoring sound) in diagnosis of Sleep-Disordered Breathing. Study Design A prospective study of consecutive patients with snoring was carried out. Methods Sixty-seven patients underwent an overnight study on ward. Patients with normal oxygen desaturation index and any periodic Breathing disturbances combined with elevated esophageal pressure were further studied with complete polysomnography. Results The patient compliance with esophageal catheter was 87%. Esophageal pressure monitoring increased effectively the detection of Sleep-Disordered Breathing with limited polygraphic recording. Sixty-seven percent of the patients with normal oxygen desaturation index and respiratory-related esophageal pressure variation had Sleep-Disordered Breathing on complete polysomnography. Increased esophageal pressure variation was significantly related with oxygen desaturation index and obstructive Sleep apnea diagnosis (P
James B. Skatrud - One of the best experts on this subject based on the ideXlab platform.
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association of Sleep Disordered Breathing and the occurrence of stroke
American Journal of Respiratory and Critical Care Medicine, 2005Co-Authors: Michael Arzt, Terry Young, Laurel Finn, James B. Skatrud, Douglas T BradleyAbstract:Rationale: Sleep-Disordered Breathing has been linked to stroke in previous studies. However, these studies either used surrogate markers of Sleep-Disordered Breathing or could not, due to cross-sectional design, address the temporal relationship between Sleep-Disordered Breathing and stroke. Objectives: To determine whether Sleep-Disordered Breathing increases the risk for stroke. Methods: We performed cross-sectional and longitudinal analyses on 1,475 and 1,189 subjects, respectively, from the general population. Sleep-Disordered Breathing was defined by the apnea–hypopnea index (frequency of apneas and hypopneas per hour of Sleep) obtained by attended polysomnography. The protocol, including polysomnography, risk factors for stroke, and a history of physician-diagnosed stroke, was repeated at 4-yr intervals. Measurements and Main Results: In the cross-sectional analysis, subjects with an apnea–hypopnea index of 20 or greater had increased odds for stroke (odds ratio, 4.33; 95% confidence interval, 1.32–14.24; p = 0.02) compared with those without Sleep-Disordered Breathing (apnea–hypopnea index, <5) after adjustment for known confounding factors. In the prospective analysis, Sleep-Disordered Breathing with an apnea–hypopnea index of 20 or greater was associated with an increased risk of suffering a first-ever stroke over the next 4 yr (unadjusted odds ratio, 4.31; 95% confidence interval, 1.31–14.15; p = 0.02). However, after adjustment for age, sex, and body mass index, the odds ratio was still elevated, but was no longer significant (3.08; 95% confidence interval, 0.74–12.81; p = 0.12). Conclusions: These data demonstrate a strong association between moderate to severe Sleep-Disordered Breathing and prevalent stroke, independent of confounding factors. They also provide the first prospective evidence that Sleep-Disordered Breathing precedes stroke and may contribute to the development of stroke.
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Association of Sleep-Disordered Breathing and the occurrence of stroke.
American Journal of Respiratory and Critical Care Medicine, 2005Co-Authors: Michael Arzt, Terry Young, Laurel Finn, James B. Skatrud, T. Douglas BradleyAbstract:Rationale: Sleep-Disordered Breathing has been linked to stroke in previous studies. However, these studies either used surrogate markers of Sleep-Disordered Breathing or could not, due to cross-sectional design, address the temporal relationship between Sleep-Disordered Breathing and stroke. Objectives: To determine whether Sleep-Disordered Breathing increases the risk for stroke. Methods: We performed cross-sectional and longitudinal analyses on 1,475 and 1,189 subjects, respectively, from the general population. Sleep-Disordered Breathing was defined by the apnea–hypopnea index (frequency of apneas and hypopneas per hour of Sleep) obtained by attended polysomnography. The protocol, including polysomnography, risk factors for stroke, and a history of physician-diagnosed stroke, was repeated at 4-yr intervals. Measurements and Main Results: In the cross-sectional analysis, subjects with an apnea–hypopnea index of 20 or greater had increased odds for stroke (odds ratio, 4.33; 95% confidence interval, 1.32–14.24; p = 0.02) compared with those without Sleep-Disordered Breathing (apnea–hypopnea index,
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Prospective study of the association between Sleep-Disordered Breathing and hypertension.
New England Journal of Medicine, 2000Co-Authors: Paul E Peppard, Terry Young, Mari Palta, James B. SkatrudAbstract:CREENING studies in the United States, Europe, and Australia have shown that a substantial proportion of the adult population has mild-to-moderate Sleep-Disordered Breathing, a condition characterized by repeated episodes of apnea and hypopnea during Sleep. 1-6 Apnea and hypopnea cause temporary elevations in blood pressure in association with blood oxygen desaturation, arousal, and sympathetic activation and may cause elevated blood pressure during the daytime and, ultimately, sustained hypertension. 7 Recent reviews judged the epidemiologic evidence relating Sleep-Disordered Breathing to hypertension to be inconclusive, but they noted that study designs were inappropriate, that there was inadequate control for confounding factors such as obesity, and that there was a dearth of prospective studies. 8,9 Since Sleep-Disordered Breathing is prevalent and treatable and the morbidity and costs of hypertension are profound, a rigorous assessment of the relation between the two conditions remains a priority. We assessed the association between Sleep-Disordered Breathing and hypertension in a prospective analysis of data from the Wisconsin Sleep Cohort Study. The Sleep Cohort Study is a population-based, longitudinal study of the natural history of Sleep-Disordered Breathing in adults. Participants complete overnight Sleep studies at four-year intervals. These studies include assessment of Sleep-Disordered Breathing (by monitored polysomnography), blood pressure, and many potential confounding factors.
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the occurrence of Sleep Disordered Breathing among middle aged adults
The New England Journal of Medicine, 1993Co-Authors: Terry Young, Mari Palta, James B. Skatrud, Jerome A Dempsey, Steven M Weber, Safwan BadrAbstract:Background Limited data have suggested that Sleep-Disordered Breathing, a condition of repeated episodes of apnea and hypopnea during Sleep, is prevalent among adults. Data from the Wisconsin Sleep Cohort Study, a longitudinal study of the natural history of cardiopulmonary disorders of Sleep, were used to estimate the prevalence of undiagnosed Sleep-Disordered Breathing among adults and address its importance to the public health. Methods A random sample of 602 employed men and women 30 to 60 years old were studied by overnight polysomnography to determine the frequency of episodes of apnea and hypopnea per hour of Sleep (the apnea-hypopnea score). We measured the age- and sex-specific prevalence of Sleep-Disordered Breathing in this group using three cutoff points for the apnea-hypopnea score (≥ 5, ≥ 10, and ≥ 15); we used logistic regression to investigate risk factors. Results The estimated prevalence of Sleep-Disordered Breathing, defined as an apnea-hypopnea score of 5 or higher, was 9 percent for w...
Mari Palta - One of the best experts on this subject based on the ideXlab platform.
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increased prevalence of Sleep Disordered Breathing in adults
American Journal of Epidemiology, 2013Co-Authors: Paul E Peppard, Terry Young, Mari Palta, Jodi H Barnet, Erika W Hagen, Khin Mae HlaAbstract:Sleep-Disordered Breathing is a common disorder with a range of harmful sequelae. Obesity is a strong causal factor for Sleep-Disordered Breathing, and because of the ongoing obesity epidemic, previous estimates of Sleep-Disordered Breathing prevalence require updating. We estimated the prevalence of Sleep-Disordered Breathing in the United States for the periods of 1988–1994 and 2007–2010 using data from the Wisconsin Sleep Cohort Study, an ongoing community-based study that was established in 1988 with participants randomly selected from an employed population of Wisconsin adults. A total of 1,520 participants who were 30–70 years of age had baseline polysomnography studies to assess the presence of Sleep-Disordered Breathing. Participants were invited for repeat studies at 4-year intervals. The prevalence of Sleep-Disordered Breathing was modeled as a function of age, sex, and body mass index, and estimates were extrapolated to US body mass index distributions estimated using data from the National Health and Nutrition Examination Survey. The current prevalence estimates of moderate to severe Sleep-Disordered Breathing (apnea-hypopnea index, measured as events/hour, ≥15) are 10% (95% confidence interval (CI): 7, 12) among 30–49-year-old men; 17% (95% CI: 15, 21) among 50–70-year-old men; 3% (95% CI: 2, 4) among 30–49-year-old women; and 9% (95% CI: 7, 11) among 50–70 year-old women. These estimated prevalence rates represent substantial increases over the last 2 decades (relative increases of between 14% and 55% depending on the subgroup).
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Prospective study of the association between Sleep-Disordered Breathing and hypertension.
New England Journal of Medicine, 2000Co-Authors: Paul E Peppard, Terry Young, Mari Palta, James B. SkatrudAbstract:CREENING studies in the United States, Europe, and Australia have shown that a substantial proportion of the adult population has mild-to-moderate Sleep-Disordered Breathing, a condition characterized by repeated episodes of apnea and hypopnea during Sleep. 1-6 Apnea and hypopnea cause temporary elevations in blood pressure in association with blood oxygen desaturation, arousal, and sympathetic activation and may cause elevated blood pressure during the daytime and, ultimately, sustained hypertension. 7 Recent reviews judged the epidemiologic evidence relating Sleep-Disordered Breathing to hypertension to be inconclusive, but they noted that study designs were inappropriate, that there was inadequate control for confounding factors such as obesity, and that there was a dearth of prospective studies. 8,9 Since Sleep-Disordered Breathing is prevalent and treatable and the morbidity and costs of hypertension are profound, a rigorous assessment of the relation between the two conditions remains a priority. We assessed the association between Sleep-Disordered Breathing and hypertension in a prospective analysis of data from the Wisconsin Sleep Cohort Study. The Sleep Cohort Study is a population-based, longitudinal study of the natural history of Sleep-Disordered Breathing in adults. Participants complete overnight Sleep studies at four-year intervals. These studies include assessment of Sleep-Disordered Breathing (by monitored polysomnography), blood pressure, and many potential confounding factors.
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Smoking as a risk factor for Sleep-Disordered Breathing.
Archives of Internal Medicine, 1994Co-Authors: David W. Wetter, Terry Young, Thomas R. Bidwell, M. Safwan Badr, Mari PaltaAbstract:Background: Recent evidence indicates that the prevalence of Sleep-Disordered Breathing is remarkably high (24% for men and 9% for women) and that the public health burden attributable to Sleep-Disordered Breathing is substantial. This investigation examines current and former cigarette smoking as potential risk factors for Sleep-Disordered Breathing. Methods: Data were from 811 adults enrolled in the University of Wisconsin Sleep Cohort Study, Madison. The Sleep Cohort Study is a longitudinal, epidemiologic study that uses nocturnal polysomnography to investigate Sleep-Disordered Breathing and other disorders of Sleep. The presence and severity of Sleep-Disordered Breathing was quantified by the frequency of apneas and hypopneas per hour of Sleep. Results: Logistic regression analyses were used to control for potential confounding factors. Compared with never smokers, current smokers had a significantly greater risk of snoring (odds ratio, 2.29) and of moderate or worse Sleep-Disordered Breathing (odds ratio, 4.44). Heavy smokers (≥40 cigarettes per day) had the greatest risk of mild Sleep-Disordered Breathing (odds ratio, 6.74) and of moderate or worse Sleep-Disordered Breathing (odds ratio, 40.47). Former smoking was unrelated to snoring and Sleep-Disordered Breathing after adjustment for confounders. Conclusions: Current cigarette smokers are at greater risk for Sleep-Disordered Breathing than are never smokers. Heavy smokers have the greatest risk while former smokers are not at increased risk for Sleep-Disordered Breathing. Thus, smoking cessation should be considered in the treatment and prevention of Sleep-Disordered Breathing. (Arch Intern Med. 1994;154:2219-2224)
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the occurrence of Sleep Disordered Breathing among middle aged adults
The New England Journal of Medicine, 1993Co-Authors: Terry Young, Mari Palta, James B. Skatrud, Jerome A Dempsey, Steven M Weber, Safwan BadrAbstract:Background Limited data have suggested that Sleep-Disordered Breathing, a condition of repeated episodes of apnea and hypopnea during Sleep, is prevalent among adults. Data from the Wisconsin Sleep Cohort Study, a longitudinal study of the natural history of cardiopulmonary disorders of Sleep, were used to estimate the prevalence of undiagnosed Sleep-Disordered Breathing among adults and address its importance to the public health. Methods A random sample of 602 employed men and women 30 to 60 years old were studied by overnight polysomnography to determine the frequency of episodes of apnea and hypopnea per hour of Sleep (the apnea-hypopnea score). We measured the age- and sex-specific prevalence of Sleep-Disordered Breathing in this group using three cutoff points for the apnea-hypopnea score (≥ 5, ≥ 10, and ≥ 15); we used logistic regression to investigate risk factors. Results The estimated prevalence of Sleep-Disordered Breathing, defined as an apnea-hypopnea score of 5 or higher, was 9 percent for w...
