Prevalence of "Moderate-to-Severe OSA" in the 40-85-Yrs. General Population

"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. . . . Between Sept 1, 2009, and June 30, 2013, we did a population-based study . . . in Lausanne, Switzerland. . . . 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." -- https://www.thelancet.com/journals/lanr ... 0/fulltext

Color added by me.

That's not OSA, mind you. It is moderate-to-severe OSA!

jnk... wrote: ↑

Wed Jan 30, 2019 10:52 am

"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. . . . Between Sept 1, 2009, and June 30, 2013, we did a population-based study . . . in Lausanne, Switzerland. . . . 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." -- https://www.thelancet.com/journals/lanr ... 0/fulltext

Color added by me.

That's not OSA, mind you. It is moderate-to-severe OSA!

Am I reading this right? almost 1/4 of all women in a random study and almost half of all men? Insane!

mean body-mass index (BMI) of 25·6

According to the latest (2014) WHO study, Switzerland is the 60th fattest country and USA is 17th.

... the upper quartile for the apnoea-hypopnoea index (>20·6 events per h) was associated independently with the presence of hypertension ... diabetes ... metabolic syndrome ... and depression.

nicholasjh1 wrote: ↑

Wed Jan 30, 2019 11:24 am

Am I reading this right? almost 1/4 of all women in a random study and almost half of all men? Insane!

The trickiness of the wording is "moderate-to-severe sleep disordered breathing." I actually cheated a bit by calling it OSA. I do that sometimes. Why is that cheating?

The problem is, if someone never reports being sleepy or tired, he is unlikely to be diagnosed with a sleep disorder or to have his sleep-breathing tested, no matter how bad his breathing is when asleep when assessed for the heck of it. And some with that high of an AHI/RDI during sleep do not consider themselves symptomatic, would never fill out a sleepiness-scale test reporting sleepiness, and would never receive an OSA diagnosis. You or your doctor or someone somewhere has to think you have a sleep problem before you get tested for one, after all.

So on the one hand, this kind of study can be used to say that 'a lot of people apparently have undiagnosed OSA'; however, on the other hand, that same data can be pointed at as proving that an OSA diagnosis may often be more a matter of subjective judgment than a matter of objective data, making measurements of RDI/AHI mostly useless and meaningless. It cuts both ways.

nicholasjh1 wrote: ↑

Wed Jan 30, 2019 11:24 am

Am I reading this right? almost 1/4 of all women in a random study and almost half of all men? Insane!

Why?

ChicagoGranny wrote: ↑

Wed Jan 30, 2019 11:48 am

According to the latest (2014) WHO study, Switzerland is the 60th fattest country and USA is 17th.

What's that got to do with it?

Once again, the comorbidity may be confused as causal.
Murphy never moves in with an overnight bag.
He brings a truckload of baggage.

My position is that if the majority of a population are likely to benefit from PAP, they should be given the opportunity to find out without having to jump through expensive medical hoops. Make the machines cheaper. Get them in the hands of the general population. The safer roads/tracks/skies and fewer health problems related to sleep will pay for it all over time. If you aren't going to screen your entire population for that common of an issue (ridiculously cost-prohibitive), make the treatment accessible to all and make response-to-therapy more important than medical testing for reasons of cost and practicality, in the name of humane treatment of fellow humans.

palerider wrote: ↑

Wed Jan 30, 2019 12:26 pm

ChicagoGranny wrote: ↑Wed Jan 30, 2019 12:48 pm
According to the latest (2014) WHO study, Switzerland is the 60th fattest country and USA is 17th.

What's that got to do with it?

You didn't read the short summary of the study?

1024 participants were men, with a mean body-mass index (BMI) of 25·6

Try getting together a sample of American men with a mean BMI as low as 25.6. It would be difficult.

chunkyfrog wrote: ↑

Wed Jan 30, 2019 12:35 pm

Once again, the comorbidity may be confused as causal.

I guess you also overlooked the reported mean BMI?

When it comes to making decisions about which segment of the population should get tested for OSA, the only thing more meaningless than BMI is mean BMI. I assumed that CG was using the wording of that summary of that study as a way to make that exact point.

jnk... wrote: ↑

Wed Jan 30, 2019 1:02 pm

When it comes to making decisions about which segment of the population should get tested for OSA, the only thing more meaningless than BMI is mean BMI. I assumed that CG was using the wording of that summary of that study as a way to make that exact point.

PaleRider and Froggy should spend a little more time on reading comprehension. The point of the study was to stay away from assuming the causes of OSA. The summary section starts right off with that:

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.

... we aimed to assess the prevalence of sleep-disordered breathing and associated clinical features in a large population-based sample.

CG, had you seen that study? I don't remember ever seeing it.

But maybe my memory isn't what it once was.

Although I'm not sure how I can judge my memory based solely on my memory of my memory.

ChicagoGranny wrote: ↑

Wed Jan 30, 2019 1:22 pm

. . . reading comprehension. . . .

Well, you do sometimes make your points in unique ways, CG.

ChicagoGranny wrote: ↑

Wed Jan 30, 2019 1:22 pm

jnk... wrote: ↑

Wed Jan 30, 2019 1:02 pm

When it comes to making decisions about which segment of the population should get tested for OSA, the only thing more meaningless than BMI is mean BMI. I assumed that CG was using the wording of that summary of that study as a way to make that exact point.

PaleRider and Froggy should spend a little more time on reading comprehension. The point of the study was to stay away from assuming the causes of OSA. The summary section starts right off with that:

Perhaps CG should try and work on her comprehension, in general.

My point was emphasizing that the role of obesity in sleep disordered breathing is an outmoded concept, As evidenced by this study, and the young, slim people that are coming into Reddit complaining about how their ignorant doctor refused them a sleep test because they are "too young or slim or female to have sleep apnea"

palerider wrote: ↑

Wed Jan 30, 2019 2:34 pm

"too young or slim or female to have sleep apnea"

I especially hate it when docs turn away the 'too female.' I don't think CG has that "problem" though.

And I think General Population needs a much better trained army, too.

I've seen this study and linked to it several times on this forum because it really surprised me when I first came across it that sleep disordered breathing is so prevalent. When I was first diagnosed I thought that SDB was the exception and that most people breathe perfectly during sleep. I honestly feel quite lucky to have been diagnosed because so many never know and so never get this treated. The impression still exists that this is a "disorder" that affects only a minority.