The prevalence and comorbidities of obstructive sleep apnea in middle-aged men and women: the Busselton Healthy Ageing Study

Jordan Cunningham; Michael Hunter; Charley Budgeon; Kevin Murray; Matthew Knuiman; Jennie Hui; David Hillman; Bhajan Singh; Alan James

doi:10.5664/jcsm.9378

The prevalence and comorbidities of obstructive sleep apnea in middle-aged men and women: the Busselton Healthy Ageing Study

J Clin Sleep Med. 2021 Oct 1;17(10):2029-2039. doi: 10.5664/jcsm.9378.

Authors

Jordan Cunningham^{1

2}, Michael Hunter^{3

4}, Charley Budgeon⁴, Kevin Murray⁴, Matthew Knuiman⁴, Jennie Hui^{3

4

5}, David Hillman¹, Bhajan Singh^{1

2}, Alan James^{1

2

3

6}

Affiliations

¹ West Australian Sleep Disorders Research Institute, Queen Elizabeth II Medical Centre, Nedlands, Western Australia.
² Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia.
³ Busselton Population Medical Research Institute, Sir Charles Gairdner Hospital, Nedlands, Western Australia.
⁴ School of Population and Global Health, The University of Western Australia, Nedlands, Western Australia.
⁵ PathWest Laboratory Medicine of Washington, Queen Elizabeth II Medical Centre, Nedlands, Western Australia.
⁶ School of Medicine and Pharmacology, The University of Western Australia, Nedlands, Western Australia; *Contributed equally.

Abstract

Study objectives: Population surveys suggest the prevalence of obstructive sleep apnea (OSA) is high and increasing and that risk factors and outcomes differ between sexes. To explore these relationships we assessed current OSA prevalence, potential risk factors and comorbidities, and their changes relative to previous estimates in the same community.

Methods: All adults on the Busselton, Australia, electoral roll born 1946-1964 were invited to participate in a general health survey. Of the 5,037 (62% response rate) respondents, 3,686 successfully completed overnight 2-channel (oximetry, airflow) sleep studies. These were scored and categorized as nil, mild, moderate, or severe OSA based on apnea-hypopnea index (< 5, ≥ 5 to < 15, ≥ 15 to < 30, and ≥ 30 events/h, respectively). Sleep scores were related to participant characteristics and health profiles. OSA prevalence was compared with previous surveys in the community.

Results: Prevalences of any and moderate-severe OSA were 57.7% and 20.2% in males and 41.7% and 10.0% in females. Matched for age group, the prevalence of moderate-severe OSA was similar to that in 2007 (males 24.6%, females 9.8%) and was higher than in 1995 (males 4.7%). OSA was associated with age, body mass index, and alcohol intake in males and age and body mass index in females. Conditions associated with OSA included hypertension and current depression in males and hypertension, skin cancer, and diabetes in females.

Conclusions: Prevalence of OSA in a middle-aged, predominantly White population in 2010-2015 was high, has increased since 1995, and has remained stable since 2007. Sex differences exist in associated features, including potential risk factors and comorbidities.

Citation: Cunningham J, Hunter M, Budgeon C, et al. The prevalence and comorbidities of obstructive sleep apnea in middle-aged men and women: the Busselton Healthy Ageing Study. J Clin Sleep Med. 2021;17(10):2029-2039.

Keywords: associations; comorbidities; obstructive sleep apnea; prevalence.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Female
Healthy Aging*
Humans
Male
Middle Aged
Polysomnography
Prevalence
Risk Factors
Sleep
Sleep Apnea, Obstructive* / epidemiology