Sleep apnoea common, poorly detectable in general population
Sleep apnoea is highly prevalent but largely undetected in the general population of middle-aged adults, with a symptom-based strategy proving to be useless for specific diagnosis, according to a recent study. Moreover, mild sleep apnoea represents a higher-risk phenotype with manifestly increased metabolic, inflammatory and cardiovascular risk factor burden, with potential public health implications.
A total of 2,205 individuals underwent home polygraphy and extensive clinical, sociodemographic, and cardiovascular assessment. Of these, 1,809 had successful polygraphy (mean age, 56.0 years; 52.3 percent female). Cardiovascular risk factors including obesity, hypertension and diabetes mellitus were significantly more common in men than in women, as was habitual snoring (36.8 percent vs 14.4 percent; p<0.001).
The respective prevalence of mild, moderate and severe sleep apnoea was 41.0 percent, 11.8 percent and 6.5 percent in men and 26.6 percent, 4.4 percent and 1.2 percent in women. Factors independently associated with the sleep disorder included male sex, age, body mass index and snoring, whereas sleepiness or tiredness were not.
Relative to the absence of the condition, mild sleep apnoea was associated with diabetes mellitus (odds ratio [OR], 2.40, 95 percent CI, 1.52–3.80), hypertension (OR, 1.76, 1.42–2.19), left ventricular hypertrophy (OR, 1.36, 1.03–1.79), arterial plaques (OR, 1.19, 0.94–1.52) and increased interleukin-6 levels (OR, 1.37, 1.10–1.72).
These observed associations were more pronounced in moderate-to-severe sleep apnoea.
Researchers called for clinical research using reliable, feasible and cost-effective diagnostic tools to develop strategies in the ambulatory diagnosis and management of sleep apnoea. Future investigations should aim at identifying specific subgroups at risk for clinically significant sleep apnoea.