Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study.
Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study.
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DOI：
10.1016/s2213-2600(15)00043-0
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发表时间：
2015-04
影响因子：
76.2
通讯作者：
Haba-Rubio, J.
中科院分区：
文献类型：
--
作者：
Heinzer, R.;Vat, S.;Marques-Vidal, P.;Marti-Soler, H.;Andries, D.;Tobback, N.;Mooser, V.;Preisig, M.;Malhotra, A.;Waeber, G.;Vollenweider, P.;Tafti, M.;Haba-Rubio, J.
睡眠呼吸障碍与主要的发病率和死亡率相关。然而，其患病率主要是在睡眠呼吸障碍或心血管疾病风险人群中进行选择性研究。考虑到记录技术的改进和用于定义呼吸事件的新标准，我们的目的是评估睡眠呼吸障碍的患病率和相关的临床特征，在一个大的人群为基础的样本。2009年9月1日至2013年6月30日，我们在瑞士洛桑进行了一项基于人群的研究（HypnoLaus）。我们邀请了3043名CoLaus/PsyCoLaus研究的连续参与者参加。最终分析包括2121人的多导睡眠图数据。1024例（48%）受试者为男性，中位年龄为57岁（IQR 49-68，范围40-85），平均体重指数（BMI）为25.6 kg/m2（SD 4.1）。参与者在家中接受了完整的多导睡眠图记录，并对糖尿病、高血压、代谢综合征和抑郁症进行了广泛的表型分析。主要结果是睡眠呼吸障碍的患病率，通过呼吸暂停-低通气指数进行评估。女性中位呼吸暂停-呼吸不足指数为6.9次/h（IQR 2.7 - 14.1），男性为14.9次/h（7.2 - 27.1）。中度至重度睡眠呼吸障碍（≥15起事件/h）的患病率在女性中为23.4%（95%CI 20.9 - 26.0），在男性中为49.7%（46.6 - 52.8）。多变量校正后，呼吸暂停-呼吸不足指数的上四分位数（>20·6事件/h）与高血压的存在独立相关（比值比1.60，95% CI 1.14 - 2.26;严重程度四分位数趋势p= 0.0292），糖尿病（2·00，1·05-3·99; p=0·0467）、代谢综合征（2·80，1·86-4·29; p<0·0001）和抑郁症（1·92，1·01-3·64; p=0·0292）。在我们以人群为基础的样本中记录的睡眠呼吸障碍的高患病率可能归因于当前记录技术和评分标准的敏感性增加。这些结果表明，睡眠呼吸障碍非常普遍，具有重要的公共卫生后果，并且应该修改该疾病的定义。洛桑生物和医学系、洛桑大学医院、瑞士国家科学基金会、Leenaards基金会、葛兰素史克、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. 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/m2 (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. 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). 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. Faculty of Biology and Medicine of Lausanne, Lausanne University Hospital, Swiss National Science Foundation, Leenaards Foundation, GlaxoSmithKline, Ligue Pulmonaire Vaudoise.