Rationale, Design, and Findings from the Wisconsin Sleep Cohort Study: Toward Understanding the Total Societal Burden of Sleep-Disordered Breathing

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At least 12 to 18 million people are affected by untreated sleep-disordered breathing (SDB), which is likely to contribute to increased cases of hypertension, cardiovascular disease, stroke, depression, and mortality. The aims of the Wisconsin Sleep Cohort Study (WSCS) were to (1) describe occurrence, including age- and sex-specific prevalence; (2) estimate, with longitudinal data, the role of SDB in cardiovascular and behavioral morbidity and mortality; and (3) identify risk factors for the development and progression of SDB. The most relevant findings from the WSCS are described. As the author notes in her summary, the cost of adverse consequences that can be attributed to SDB is likely to be staggering, a burden that could be decreased by risk factor reduction, with weight loss the most likely candidate.

Section snippets

The Emerging Need to Understand the Health Burden of Sleep-Disordered Breathing

In this article, SDB refers to the condition of repeated apnea and hypopnea events during sleep, most commonly indicated by the number of apnea and hypopnea events per hour of sleep (apnea-hypopnea index [AHI]). (Because most apnea and hypopnea events detected in population studies are due to upper airway collapse and increased airway resistance, with few events due to lack of respiratory muscle activation [central apnea], SDB is used in this report to reflect mainly obstructive sleep apnea.)

Design of the wisconsin sleep cohort study

The primary goal of the WSCS was to investigate the natural history of SDB and other sleep disorders, with the long-term goal of better understanding the total societal burden of SDB. Specifically, our aims were to (1) describe occurrence, including age- and sex-specific prevalence for mild, moderate, and severe SDB; (2) estimate, with longitudinal data, the role of SDB in cardiovascular and behavioral morbidity and mortality; and (3) identify risk factors for the development and progression of

Findings from the wisconsin sleep cohort study

In keeping with the original long-term goal of determining the total societal burden of SDB, the most relevant findings from the WSCS are described below, organized into the three components of the total burden: the number of affected people, the cost of SDB, and the effects of modifying factors.

Summary

In summary, findings from the WSCS and other population studies indicate

  • 1.

    The first component of total social or public burden of SDB (see Fig. 1) poses a significant concern: The number of persons who have untreated SDB is large, with at least 12 to 18 million affected adults. Of additional concern, the prevalence will rise markedly on the coattails of the obesity epidemic. Similarly, as the population of the United States ages, the prevalence of SDB will increase because of the accumulation of

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    This work was supported by grants R01HL62252, RR03186, and R01AG14124 from the National Institutes of Health.

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