Predictors of longitudinal change in sleep-disordered breathing in a nonclinic population.
OBJECTIVE
To quantify and identify the determinants of the 5-year change in the respiratory disturbance index (RDI).


METHODS
Longitudinal cohort study (Cleveland Family Study). Multivariate analyses were used to quantify baseline RDI and RDI change.


METHODS
Community-based study.


METHODS
486 cohort members (62% from families of probands with sleep-disordered breathing [SDB])--mean age 31.6 +/- 17.9 (SD) years, 60% female, 21% Black ethnicity--who underwent 2 assessments over 5.3 +/- 0.9 (SD) years.


METHODS
NA.


METHODS
The RDI was measured twice over approximately 5 years with in-home monitoring. Symptoms and medical histories were obtained from standardized questionnaires, and weight, height, and blood pressure were measured.


RESULTS
The prevalence of SDB (defined by a RDI > or = 15), increased from 13.7% to 23.4% (P < 0.01) in men and from 8.3% to 11.4% (P = 0.13) in females. Baseline and follow-up mean RDIs were 6.0 +/- 10.0 and 8.6 +/- 14.3; both were higher in older individuals, in men, and in those with a higher body mass index. Median 5-year change in RDI varied nonlinearly with age (-0.1, 1.1, 2.3, and 0.9, for those < 18, 19-40, 41-54, and > or = 55 years, respectively) and obesity (2.8 vs -0.1, for the top versus lowest body mass index quartile). The effects of changing weight and aging varied in population subgroups. At any given age and weight, the RDI increased less in women.


CONCLUSIONS
Longitudinal change in the RDI varies nonuniformly with age, sex, and weight. Older heavier men may experience the highest rate of increase in RDI over time and, thus, may benefit most from prospective monitoring.
Redline
Susan
S
Department of Pediatrics, Division of Clinical Epidemiology, Case Western Reserve University, Rainbow Babies and Children's Hospital, Cleveland, Ohio 44106-6003, USA. sxr15@po.cwru.edu
Schluchter
Mark D
MD
Larkin
Emma K
EK
Tishler
Peter V
PV
D000328:Adult; D000375:Aging / Q000502:physiology; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011159:Population Surveillance; D011446:Prospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology*