The Sleep Heart Health Study: Design, Rationale, and Methods
Abstract
The Sleep Heart Health Study (SHHS) is a prospective cohort study designed to investigate obstructive sleep apnea (OSA) and other sleep-disordered breathing (SDB) as risk factors for the development of cardiovascular disease. The study is designed to enroll 6,600 adult participants aged 40 years and older who will undergo a home polysomnogram to assess the presence of OSA and other SDB. Participants in SHHS have been recruited from cohort studies in progress. Therefore, SHHS adds the assessment of OSA to the protocols of these studies and will use already collected data on the principal risk factors for cardiovascular disease as well as follow-up and outcome information pertaining to cardiovascular disease. Parent cohort studies and recruitment targets for these cohorts are the following: Atherosclerosis Risk in Communities Study (1,750 participants), Cardiovascular Health Study (1,350 participants), Framingham Heart Study (1,000 participants), Strong Heart Study (600 participants), New York Hypertension Cohorts (1,000 participants), and Tucson Epidemiologic Study of Airways Obstructive Diseases and the Health and Environment Study (900 participants). As part of the parent study follow-up procedures, participants will be surveyed at periodic intervals for the incidence and recurrence of cardiovascular disease events. The study provides sufficient statistical power for assessing OSA and other SDB as risk factors for major cardiovascular events, including myocardial infarction and stroke.
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The Wisconsin Sleep Cohort and SHHS found a general prevalence of 24% in men and 9% in women using the alternative hypopnea definition of ≥4% oxygen desaturation.
“These studies found a general prevalence of 24% in men, 9% in women using the alternative definition of hypopnea (≥4% oxygen desaturation).”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [91]
The Abstract reports OSA prevalence of 4% in men and 2% in women, not the claimed 24% and 9%; those figures may concern a different definition, so this is not a direct contradiction. The Home polysomnography section describes SHHS hypopnea scoring but does not report prevalence using a ≥4% oxygen-desaturation threshold. Searches for the claimed percentages and the Wisconsin cohort did not locate that finding in our copy. (LLM, conf=0.76)
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- Authors
- Quan, S. F., Howard, B. V., Iber, C., Kiley, J. P., Nieto, F. J., O’Connor, G. T., Rapoport, D. M., Redline, S. S., Robbins, J. A., Samet, J. M., & WAHL, P. W.
- Affiliations
- University of Arizona (US)
- University of Minnesota (US)
- National Heart, Lung, and Blood Institute (US)
- Johns Hopkins University (US)
- Boston University (US)
- New York University (US)
- Case Western Reserve University (US)
- University of California, Davis (US)
- University of Washington (US)
- Corresponding author
- Stuart F. Quan
- ORCID
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 1997-12-01
- Volume
- 20
- Issue
- 12
- Pages
- 1077-85
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- OpenAlex
- W160785014
- Cited by
- 1,331
- References
- 0
- Citations by year
- 2026: 45 · 2025: 131 · 2024: 157 · 2023: 113 · 2022: 86 · 2021: 97 · 2020: 64 · 2019: 68 · 2018: 52 · 2017: 32 · 2016: 35 · 2015: 36 · 2014: 33 · 2013: 36 · 2012: 35
- FWCI
- 4.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- SLEEP (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5u01hl053940-05)
- National Heart, Lung, and Blood Institute (U01 HL 53940, U01HL53938, U01HL053941, U01HL053938, U01 HL 53941)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pharmacology › Apelin-related biomedical research
- Keywords
- Sleep Heart Health Study, obstructive sleep apnea, sleep-disordered breathing, cardiovascular risk factors, home polysomnography, myocardial infarction, stroke, cardiovascular disease incidence, Atherosclerosis Risk in Communities Study, Framingham Heart Study, Strong Heart Study, Cardiovascular Health Study
- MeSH terms
- Adult, Aged, Aged, 80 and over, Arteriosclerosis, Coronary Disease, Female, Humans, Hypertension, Longitudinal Studies, Male, Middle Aged, Positive-Pressure Respiration, Prospective Studies, Research Design, Sleep Apnea Syndromes, Cohort Studies, Polysomnography
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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