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Cited by 640Obstructive Sleep Apnea ResearchSleep and related disordersNeuroscience of respiration and sleep

Predictors and prevalence of obstructive sleep apnoea and snoring in 1001 middle aged men.

Open access
Stradling, J R, Crosby, J H·1991·Thorax
DOI 10.1136/thx.46.2.85PMC PMC462949
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Abstract

One thousand and one men, aged 35-65 years, were identified from the age-sex register of one group general practice. Over four years 900 men were visited at home and asked questions about symptoms potentially related to sleep apnoea and snoring. Height, weight, neck circumference, resting arterial oxygen saturation (SaO2), and spirometric values were also determined. All night oximetry was then performed at home and the tracing analysed for the number of dips in SaO2 of more than 4%. Subjects with more than five dips of 4% SaO2 or more per hour were invited for sleep laboratory polysomnography. Seventeen per cent of the men admitted to snoring "often." Multiple linear regression techniques identified and ranked neck circumference (r2 = 7.2%), cigarette consumption (r2 = 3.4%), and nasal stuffiness (r2 = 2%) as the only significant independent predictors of snoring. Together these account for at least a sixfold variation in the likelihood of being an "often" snorer. Forty six subjects (5%) had greater than 4% SaO2 dip rates of over five an hour and 31 of these had full sleep studies. Three subjects had clinically obvious and severe symptomatic obstructive sleep apnoea, giving a prevalence of three per 1001 men (0.3%; 95% confidence interval 0.07-0.9%). Eighteen men had obstructive sleep apnoea only when supine and in 10 the cause of the SaO2 dipping on the original home tracing was not elucidated. The greater than 4% SaO2 dip rates correlated with the history of snoring. Multiple linear regression techniques identified and ranked neck circumference (r2 = 7.9%), alcohol consumption (r2 = 3.7%), age (r2 = 1%) and obesity (r2 = 1%) as the only significant independent predictors of the rate of overnight hypoxic dipping. This study shows that snoring in this randomly selected population correlates best with neck size, smoking, and nasal stuffiness. Obstructive sleep apnoea, defined by nocturnal hypoxaemia, correlates best with neck size and alcohol, and less so with age and general obesity.

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  • Neck circumference or collar size is associated with OSA in adults.

    “Neck circumference (NC) or collar size is associated with OSA in adults.184,528–534”

    From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [533]

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Research works printed but not linked: 11

  1. [4]4. Stradling JR, Crosby JH. Reladon between synsic hyper- tenson and sleephypo or snoring:anlysis in 748 men drawn from general practice. BMJ 1990;30:75-8.
  2. [5]5. Gunawardna KA,Houston K, Smith AP. Evaluation ofthe turbine pocket spirometer. Thorax 1987;42:689-93.
  3. [8]8. Cody RP, Smith JK. Appliedstatisticsand the SASprogram- ming language. 2nd edn. New York: Elsevier, 1987.
  4. [11]11. Stradling J, Mitchell J. Reproducibility of home oximeter tracings. J Amb Monit 1989;2:203-8.
  5. [15]15. Kripke D, Mason W, Bloomquist J, Cobarrubias M, Engler R, Ancoli-Israel S. Relationship of respitrace apnea- hypopnea counts and 4% desaturations. Sleep Res 1988;17:208.
  6. [16]16. Gould GA, Whyte KF, Airlie MAA, Rhind GB, Catterall JR, Shapiro CM, Douglas NJ. Criteria for diagnosing abnormal breathing during sleep [abstract]. Thorax 1987;42:722.
  7. [21]21. Stradling JR, Warley A, Sharpley A. Wrist actigraphic assessment of sleep. Sleep Res 1987;16:586-6.
  8. [25]25. Katz I, Stradling J, Slutsky AS, Zamel N, Hoffstein V. Do patients with sleep apnea have a short fat neck? [abstract]. Am Rev Respir Dis 1989;139:A622.
  9. [29]29. Lavie P. Incidence of sleep apnea in a presumably healthy working population. Skep 1983;6:312-8.
  10. [31]31. Lugaresi E, Cirignotta F, Gerardi R, Montagna P. Snoring and sleep apnea: natural history of heavy snorers disease. In: Guilleinault C, Partinen M, eds. Obstructive sleep apnea syndrow. New York: Raven Press, 1990:25-36.
  11. [35]35. Stradling JR, Thomas G, Williams P, Warley ARH, Freeland A. Effect of adenotonsillectomy on noctumal hypoxaemia, sleep disturbance and symptomsin snoring children. Lancet 1990;335:249-53.

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Authors
Stradling, J. R., & Crosby, J. H.
Affiliations
Churchill Hospital (GB)
ORCID
Stradling, J R
Venue
Thorax
Publisher
BMJ
Published
1991-02-01
Volume
46
Issue
2
Pages
85-90
ISSN
0040-6376 (ISSN-L)
DOI
10.1136/thx.46.2.85
PMC
PMC462949
OpenAlex
W2162747978
Semantic Scholar
289f8bb34fa57b233f1b0cd0eca3d17cd0e929d4
Cited by
640
References
26
Citations by year
2026: 2 · 2025: 4 · 2024: 11 · 2023: 7 · 2022: 16 · 2021: 15 · 2020: 9 · 2019: 11 · 2018: 12 · 2017: 17 · 2016: 24 · 2015: 18 · 2014: 25 · 2013: 29 · 2012: 28
FWCI
10.44
Type
journal article
Language
en
Open access
Locations
  • Thorax (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Wellcome Trust
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
obstructive sleep apnea, snoring, prevalence, middle-aged men, neck circumference, nocturnal hypoxemia, arterial oxygen saturation, alcohol consumption, smoking, nasal obstruction, obesity
MeSH terms
Adult, Alcohol Drinking, Hypoxia, Humans, Male, Middle Aged, Neck, Oximetry, Prospective Studies, Sleep Apnea Syndromes, Smoking, Snoring, Nasal Obstruction, Prevalence

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