Increased Prevalence of Sleep-Disordered Breathing in Adults
Open accessAbstract
Sleep-disordered breathing is a common disorder with a range of harmful sequelae. Obesity is a strong causal factor for sleep-disordered breathing, and because of the ongoing obesity epidemic, previous estimates of sleep-disordered breathing prevalence require updating. We estimated the prevalence of sleep-disordered breathing in the United States for the periods of 1988-1994 and 2007-2010 using data from the Wisconsin Sleep Cohort Study, an ongoing community-based study that was established in 1988 with participants randomly selected from an employed population of Wisconsin adults. A total of 1,520 participants who were 30-70 years of age had baseline polysomnography studies to assess the presence of sleep-disordered breathing. Participants were invited for repeat studies at 4-year intervals. The prevalence of sleep-disordered breathing was modeled as a function of age, sex, and body mass index, and estimates were extrapolated to US body mass index distributions estimated using data from the National Health and Nutrition Examination Survey. The current prevalence estimates of moderate to severe sleep-disordered breathing (apnea-hypopnea index, measured as events/hour, ≥15) are 10% (95% confidence interval (CI): 7, 12) among 30-49-year-old men; 17% (95% CI: 15, 21) among 50-70-year-old men; 3% (95% CI: 2, 4) among 30-49-year-old women; and 9% (95% CI: 7, 11) among 50-70 year-old women. These estimated prevalence rates represent substantial increases over the last 2 decades (relative increases of between 14% and 55% depending on the subgroup).
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The association between BMI and OSA decreases with age, and after age 60 years may be less significant.
“However, this association with BMI decreases with age, and after age 60 years may be less significant.95”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [95]
The Results report that BMI was more strongly related to sleep-disordered breathing prevalence in the younger age stratum, supporting the age-related weakening of the association. The paper compares younger adults with a 50–70-year-old group; it does not establish a change specifically after age 60 or show that the association becomes statistically less significant then. The supplied Results passage has no page number. (LLM, conf=0.88)
Experimental — accuracy not yet measuredOSA is prevalent in 44.6% of men and 13.5% of women aged 30-49 years with BMI 30-39.9 kg/m2, compared to 7% of men and 1.4% of women whose BMI is less than 25 kg/m2.
“OSA is prevalent in 44.6% of men and 13.5% of women aged 30–49 years with BMI of 30–39.9 kg/m2, compared to 7% of men and 1.4% of women whose BMI is less than 25 kg/m2.95”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [95]
Table 2 (indexed under Discussion; page not provided) gives all four cited estimates for adults aged 30–49 in the specified BMI groups. But it labels them as mild-to-severe sleep-disordered breathing (AHI ≥5), not OSA; the Discussion describes more restrictive criteria for a positive indication of OSA. The figures are supported, but their characterization as OSA prevalence is not. (LLM, conf=0.86)
Experimental — accuracy not yet measuredOSA 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 [95]
The Discussion (p. 1009) estimates substantial prevalence of sleep-disordered breathing among US adults aged 30–70 and says the measured definitions meet criteria for an indication of OSA. The paper mentions hypertension as a possible long-term consequence of sleep-disordered breathing, but does not establish that hypertension is highly prevalent in the general population. (LLM, conf=0.88)
Experimental — accuracy not yet measuredSleep debt, circadian misalignment, and sleep disruption from obstructive sleep apnea are widespread in modern society.
“Sleep debt, circadian misalignment and sleep disruption from obstructive sleep apnea is widespread in modern society and accumulates with life because recovery sleep is not completely restorative.”
From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [12]
The opening section identifies fragmented sleep as an immediate effect of sleep-disordered breathing, and the Discussion (p. 1009) estimates substantial prevalence among US adults aged 30–70. The paper does not address whether sleep debt or circadian misalignment are widespread, or whether incomplete restoration by recovery sleep causes these problems to accumulate with age. (LLM, conf=0.88)
Experimental — accuracy not yet measuredApproximately 10% of the general population fulfil diagnostic criteria for OSA.
“it is estimated that approximately 10% of the general population fulfil diagnostic criteria for OSA [20].”
From Co-morbid insomnia and sleep apnea (COMISA): Prevalence, consequences, methodological considerations, and recent randomized controlled trials (2019) · cites this paper as [20]
The Discussion (p. 1009) estimates that 13% of men and 6% of women aged 30–70 have moderate-to-severe sleep-disordered breathing and says this meets Medicare criteria for a positive indication of OSA. Those figures make approximately 10% plausible for the adults studied, but the paper does not estimate prevalence for the general population across all ages. (LLM, conf=0.86)
Experimental — accuracy not yet measured
As BMI increases, the risk of OSA rises, with an increase in prevalence of AHI ≥15 from 3.6% in normal weight to 56% in those with BMI ≥40 among men aged 50-70 years.
“As BMI increases, the risk of OSA rises with an increase in prevalence of AHI ≥ 15 from 3.6% in normal weight to 56% in those with BMI ≥40 among men aged 50–70 years.95”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [95]
An updated estimate based on Wisconsin data in 2013 indicated higher rates of OSA in 14% of men and 5% of women ages 30-70 in the US over time, attributed to changes in population obesity.
“An updated estimate based on the Wisconsin data in 2013 indicated higher rates of OSA in 14% of men and 5% of women ages 30–70 in the US over time, attributed to changes in population levels of obesity.95”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [95]
Obesity is one of the most significant risk factors for SDB.
“Obesity is one of the most significant risk factors for SDB.95,156,189,190”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [95]
Substantial increases in OSA prevalence were seen over the span of two decades, ranging between 14% and 55% depending on the subgroup.
“Substantial increases in OSA prevalence were seen over the span of two decades, ranging between 14% and 55% depending on the subgroup.”
From Obstructive sleep apnea: transition from pathophysiology to an integrative disease model (2022) · cites this paper as Peppard et al., 2013
The prevalence rates of moderate-to-severe OSA (AHI ≥15 events/h) in the 2007-2010 period were 10% among men aged 30-49 years; 17% among men aged 50-70 years; 3% among women aged 30-49 years; and 9% among women aged 50-70 years.
“The prevalence rates of moderate‐to‐severe OSA in the latter period were 10% among men aged 30–49 years; 17% among men aged 50–70 years; 3% among women aged 30–49 years; and 9% among women aged 50–70 years.”
From Obstructive sleep apnea: transition from pathophysiology to an integrative disease model (2022) · cites this paper as Peppard et al., 2013
OSA is a male-preponderant disease that is more prevalent with advanced age, particularly in the presence of obesity.
“It is a male-preponderant disease that is more prevalent with advanced age, particularly in the presence of obesity [12, 102].”
From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [12]
The prevalence of OSA has been estimated to be 14% of men and 5% of women in a population-based study using an AHI cutoff of ≥ 5 events/h with hypopneas associated with 4% oxygen desaturations and clinical symptoms to define OSA.
“The prevalence of OSA has been estimated to be 14% of men and 5% of women, in a population-based study utilizing an AHI cutoff of ≥ 5 events/h (hypopneas associated with 4% oxygen desaturations) combined with clinical symptoms to define OSA.6”
From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [6]
The prevalence of an increased AHI was higher than the prevalence of EDS.
“As in the foregoing study, the prevalence of an increased AHI was higher than the prevalence of EDS.”
From Obstructive sleep apnea: transition from pathophysiology to an integrative disease model (2022) · cites this paper as Peppard et al., 2013
The Results and Tables 2–6 report the prevalence of elevated AHI alone and of elevated AHI with concomitant daytime sleepiness. They do not report the prevalence of excessive daytime sleepiness (EDS) alone, so their figures cannot establish the claimed comparison. I searched for an EDS-only prevalence estimate and a direct comparison with AHI prevalence. (LLM, conf=0.76)
Experimental — accuracy not yet measuredSleep apnea prevalence is estimated at 27% to 34% among men 30 to 70 years of age and 9% to 28% among women in the same age group.
“Sleep apnea, another common sleep disorder defined as at least 5 respiratory events (apnea or hypopnea) per hour of sleep on average, has an estimated prevalence of 27% to 34% among men 30 to 70 years of age and 9% to 28% among women in the same age group.”
From Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association (2016) · cites this paper as [3]
Men are more likely to have obstructive sleep apnea, more likely to have difficulty adhering to sleep apnea treatment, and more likely to die as a result of complications or consequences of sleep apnea.
“For example, men are more likely to have obstructive sleep apnea,139 are more likely to have difficulty adhering to sleep apnea treatment,165,166 and are more likely to die as a result of complications or consequences of sleep apnea.167”
From Sleep, Health, and Society (2017) · cites this paper as [139]
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“The current prevalence rate of moderate to severe OSA (apneahypopnea index [AHI] $ 15 events/h) is about 10% to 20%.(4) This estimated prevalence rate represents a substantial increase over the past 2 decades.”
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- Authors
- Peppard, P. E., Young, T., Barnet, J. H., Palta, M., Hagen, E. W., & Hla, K. M.
- Affiliations
- University of Wisconsin–Madison (US)
- Corresponding author
- Peppard, P. E.
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-04-14
- Volume
- 177
- Issue
- 9
- Pages
- 1006-1014
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- PMC
- PMC3639722
- OpenAlex
- W2117834225
- Semantic Scholar
- 04acb616e4636054e9857f3d1e7fcf5e8b5e43ac
- Cited by
- 4,618
- References
- 43
- Citations by year
- 2026: 227 · 2025: 343 · 2024: 305 · 2023: 357 · 2022: 412 · 2021: 427 · 2020: 443 · 2019: 430 · 2018: 450 · 2017: 383 · 2016: 340 · 2015: 300 · 2014: 161 · 2013: 27 · 2012: 3
- FWCI
- 191.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Epidemiology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Wisconsin-Madison (1UL1RR025011)
- National Institutes of Health (UL1TR000427)
- School of Medicine and Public Health, University of Wisconsin-Madison
- National Institute on Aging (R01AG014124, R01AG 14124, R01AG036838)
- National Heart, Lung, and Blood Institute (R01HL062252, R01HL 62252)
- National Center for Research Resources (UL1RR025011)
- National Center for Advancing Translational Sciences
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32HD049302)
- 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, obesity, body mass index, apnea-hypopnea index, Wisconsin Sleep Cohort Study, sex differences, age differences, obesity epidemic, polysomnography
- MeSH terms
- Adult, Aged, Female, Health Surveys, Humans, Disorders of Excessive Somnolence, Male, Obesity, Severity of Illness Index, Sleep Apnea Syndromes, United States, Wisconsin, Cohort Studies, Body Mass Index, Prevalence, Logistic Models, Polysomnography, Sex Distribution
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