title: Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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/m(2) (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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  Faculty of Biology and Medicine of Lausanne, Lausanne University Hospital, Swiss National Science Foundation, Leenaards Foundation, GlaxoSmithKline, Ligue Pulmonaire Vaudoise.
authors: Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland; Pulmonary Department, University Hospital of Lausanne, Lausanne, Switzerland. Electronic address: raphael.heinzer@chuv.ch.
authors: R
authors: R
authors: Heinzer
authors: Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland; Pulmonary Medicine Department, University Hospital of Montreal, Montreal, QC, Canada.
authors: S
authors: S
authors: Vat
authors: Department of Internal Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
authors: P
authors: P
authors: Marques-Vidal
authors: Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland.
authors: H
authors: H
authors: Marti-Soler
authors: Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland.
authors: D
authors: D
authors: Andries
authors: Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland.
authors: N
authors: N
authors: Tobback
authors: Laboratory Department, University Hospital of Lausanne, Lausanne, Switzerland.
authors: V
authors: V
authors: Mooser
authors: Psychiatry Department, University Hospital of Lausanne, Lausanne, Switzerland.
authors: M
authors: M
authors: Preisig
authors: University of Southern California San Diego, Division of Pulmonary and Critical Care, La Jolla, CA, USA.
authors: A
authors: A
authors: Malhotra
authors: Department of Internal Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
authors: G
authors: G
authors: Waeber
authors: Department of Internal Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
authors: P
authors: P
authors: Vollenweider
authors: Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland; Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland.
authors: M
authors: M
authors: Tafti
authors: Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland.
authors: J
authors: J
authors: Haba-Rubio
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D003863:Depression / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D050177:Overweight / Q000453:epidemiology; D017286:Polysomnography; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000453:epidemiology; D020182:Sleep Apnea, Central / Q000453:epidemiology*; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology; D013557:Switzerland / Q000453:epidemiology