Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study
Open accessAbstract
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.Findings 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).Interpretation 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.Funding Faculty of Biology and Medicine of Lausanne, Lausanne University Hospital, Swiss National Science Foundation, Leenaards Foundation, GlaxoSmithKline, Ligue Pulmonaire Vaudoise.
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OSA and hypertension are highly prevalent conditions in the general population.
“OSA and hypertension (HTN) are highly prevalent conditions in the general population.95,97,677”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [97]
The Findings report a high prevalence of moderate-to-severe sleep-disordered breathing in the population-based cohort: 23.4% of women and 49.7% of men. The paper examines hypertension as an associated condition, but the cited passages do not establish that hypertension itself is highly prevalent in the general population. (LLM, conf=0.84)
Experimental — accuracy not yet measuredMany patients with obstructive sleep apnea do not report excessive daytime sleepiness or fatigue, with some patients reporting only minimal symptoms, which have important implications for management and disease outcomes.
“However, many patients do not report EDS or fatigue with some patients reporting only minimal symptoms (Heinzer et al., 2015), which have important implications for management and disease outcomes (Gagnadoux et al., 2016).”
From Obstructive sleep apnea: transition from pathophysiology to an integrative disease model (2022) · cites this paper as Heinzer et al., 2015
The Results (page not available) report no association between sleep-disordered-breathing severity and daytime sleepiness; mean Epworth scores in participants with moderate-to-severe disease were below the paper’s threshold for excessive daytime sleepiness (Procedures, page not available). This supports the point about limited sleepiness, but the cited passages do not establish that many patients lack fatigue or have minimal symptoms overall. The management-and-outcomes clause is attributed to Gagnadoux et al., not Heinzer et al. (LLM, conf=0.82)
Experimental — accuracy not yet measuredIn the HypnoLaus study, the prevalence of OSA in a population-based sample was 23.4% in women and 49.7% in men.
“Heinzer et al. found that the prevalence of OSA in their population‐based sample was 23.4% in women and 49.7% in men.”
From Obstructive sleep apnea: transition from pathophysiology to an integrative disease model (2022) · cites this paper as Heinzer et al., 2015
The Results report the cited percentages for moderate-to-severe sleep-disordered breathing, defined by an apnoea-hypopnoea index of at least 15 events per hour. The claim omits that severity threshold and calls the figures the prevalence of OSA overall; the Results give higher figures when mild cases are included. (LLM, conf=0.90)
Experimental — accuracy not yet measuredOnly a minority of men and women with an AHI of ≥15 events/h had concomitant EDS.
“only a minority of men and women with an AHI of ≥15 events/h had concomitant EDS.”
From Obstructive sleep apnea: transition from pathophysiology to an integrative disease model (2022) · cites this paper as Heinzer et al., 2015
The Results report that, among participants with moderate-to-severe sleep-disordered breathing (AHI ≥15), mean Epworth scores were 5.6 in women and 6.6 in men. The Procedures define excessive daytime sleepiness as a score greater than 10. These findings are consistent with the claim, but the passages do not report the proportion with excessive daytime sleepiness in either group, so they do not establish that it was a minority in both. (LLM, conf=0.78)
Experimental — accuracy not yet measuredA more recent population-based study in Switzerland found a very high prevalence: 23% in women and 50% in men.
“A more recent population-based study in Switzerland found a very high prevalence: 23% in women and 50% in men.97”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [97]
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References 40 · Cited by 2,481
- Authors
- 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.
- Affiliations
- Centre Hospitalier Universitaire Vaudois (CH)
- University of Southern California (US)
- Corresponding author
- Heinzer, R
- Venue
- The Lancet Respiratory Medicine
- Publisher
- Elsevier BV
- Published
- 2015-04
- Volume
- 3
- Issue
- 4
- Pages
- 310-318
- ISSN
- 2213-2600 (ISSN-L)
- PMC
- PMC4404207
- OpenAlex
- W2011114870
- Cited by
- 2,481
- References
- 40
- Citations by year
- 2026: 137 · 2025: 218 · 2024: 234 · 2023: 215 · 2022: 279 · 2021: 292 · 2020: 288 · 2019: 257 · 2018: 241 · 2017: 157 · 2016: 114 · 2015: 36 · 2013: 1 · 2012: 1
- FWCI
- 134.57
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Lancet Respiratory Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- IRIS (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion, other-oa)
- Funders
- National Science Foundation (33CS30-139468, 33CS30-148401, 33CSCO-122661)
- GlaxoSmithKline (3200B0–105993, 33CSCO-122661, 3200B0-118308, 33CS30-148401, 33CS30-139468)
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (148401, 122661, 33CSCO, 118308, 105993, 3200B0, 33CS30, 139468)
- Fondation Leenaards
- Chinese Society of Clinical Oncology
- National Institutes of Health (7k24hl093218-06)
- National Heart, Lung, and Blood Institute (K24 HL-093218, R01HL085188)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Keywords
- sleep-disordered breathing, prevalence, apnea-hypopnea index, home polysomnography, hypertension, diabetes mellitus, metabolic syndrome, obesity, sex differences, cardiovascular risk factors, obstructive sleep apnea, snoring, daytime sleepiness, body mass index
- MeSH terms
- Adult, Aged, Aged, 80 and over, Alcohol Drinking, Depression, Diabetes Mellitus, Female, Humans, Hypertension, Male, Middle Aged, Risk Factors, Severity of Illness Index, Sleep Apnea Syndromes, Smoking, Switzerland, Body Mass Index, Prevalence, Logistic Models, Odds Ratio, Polysomnography, Age Distribution, Sleep Apnea, Obstructive, Sleep Apnea, Central, Metabolic Syndrome, Overweight
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