Epidemiology of Sleep-Disordered Breathing in Adults

成人睡眠呼吸障碍的流行病学

基本信息

批准号：
7652075
负责人：
TERRY B Young
金额：
$ 105.88万
依托单位：
UNIVERSITY OF WISCONSIN-MADISON
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-07-01 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7652075
关键词：
Address Adult Age Age of Onset Age-Years Age-associated memory impairment Aging Alleles Apnea Apolipoprotein E Arts Attention Awareness Biological Markers Birth Blood Vessels Cardiovascular Diseases Cardiovascular Physiology Cardiovascular system Carotid Artery Plaques Cerebrovascular Disorders Characteristics Chronic Clinical Cohort Studies Communities Coronary heart disease Data Decision Making Development Diagnosis Disease Dual-Energy X-Ray Absorptiometry Echocardiography Elderly Epidemic Epidemiology Equilibrium Event Frequencies Functional disorder General Population Goals Grant Health Health Policy Health Promotion Heart High Prevalence Hypersomnolence Hypertension Image Impaired cognition Incidence Individual Injury Intervention Knowledge Left Ventricular Mass Longitudinal Studies Measures Memory Monitor Morbid Obesity Morbidity - disease rate Natural History Neuropsychological Tests Obesity Outcome Participant Patients Peer Review Peripheral Resistance Persons Polysomnography Population Population Study Positioning Attribute Prevalence Prevention Protocols documentation Public Health Publications Pulse Pressure Questionnaires Reaction Time Recording of previous events Research Resources Risk Risk Factors Role Sampling Seminal Severities Sleep Sleep Apnea Syndromes Sleep Disorders Sleeplessness Stereotyping Stroke Subgroup Techniques Testing Translations Ultrasonography Vascular Diseases Ventricular Wisconsin Woman World War II age related aged arterial tonometry base case finding clinical application cognitive function cohort demographics design executive function experience falls follow-up hypnotic indexing intima media men middle age mortality pre-clinical premature pressure prevent programs psychosocial public health relevance stressor vigilance

项目摘要

DESCRIPTION (provided by applicant): Sleep disordered breathing (SDB), described by the frequency of apnea and hypopnea events during sleep, is widely recognized as a highly prevalent but under-diagnosed condition that has a significant role in hypertension, cardiovascular and cerebrovascular disease, impaired cognitive function, hypersomnolence, decrements in daytime functioning and premature all-cause and cardiovascular mortality. Population studies over the 20 years have established the high prevalence of SDB and begun to identify the correlates and outcomes of SDB, but critical questions must be addressed to craft clinical and public health policy regarding the prevention and treatment of SDB. Important period effects that will change the SDB burden are occurring in the US, including aging of the large post World War II birth cohort, enhanced survival of older adults who have had different exposures during midlife to SDB risk factors, and an obesity epidemic. Data to address the public health burden of SDB under these new conditions are lacking. The research proposed here is designed to address the gap in understanding the burden of untreated SDB. With a 5-year continuation of the Wisconsin Sleep Cohort Study, a longitudinal study of SDB and other sleep disorders, we will continue to follow a community sample (n= 1522) of men and women, 30-60 years of age at baseline, who will have aged to 55-85 years over the continuation. With data spanning up to 25 years, with individual trajectories of data on SDB and other factors from middle to older age, we will optimally estimate the role of untreated SDB in preclinical and clinically evident cardiovascular and cerebrovascular disease (CVD/stroke), cognitive impairment, and chronic daytime dysfunction. We will also investigate the impact of age-related risk factors on sleep disorders. To achieve these goals, we will conduct follow-up protocols with overnight polysomnography, state of the art body habitus measures including DXA, echocardiography and vascular imaging, neuropsychologic test batteries, and other tests to extend our rich data on SDB status, risk factors, and outcomes. PUBLIC HEALTH RELEVANCE: The finding from the proposed longitudinal Wisconsin Sleep Cohort Study on the occurrence and progression of SDB, in a population transitioning from late middle to older age, and on the role SDB has in the development of morbidity and mortality will contribute needed new knowledge of public health significance. The findings will inform clinical decision making regarding what level of severity of SDB should be identified, whether subgroups should be targeted for case-finding, and decrease inequities due to referral and treatment based on incorrect SDB patient stereotypes. The findings will also inform public health policy regarding needed new resources, public programs designed to set goals to increase awareness of SDB, and to prevent SDB occurrence and progression, and to include SDB in federal health promotion and monitoring programs.

描述（由申请人提供）：睡眠呼吸障碍（SDB），以睡眠期间呼吸暂停和呼吸不足事件的频率来描述，被广泛认为是一种高度普遍但诊断不足的疾病，在高血压、心脑血管疾病中具有重要作用、认知功能受损、嗜睡、白天功能下降以及过早全因死亡率和心血管死亡率。 20 年来的人口研究已经确定了 SDB 的高患病率，并开始确定 SDB 的相关性和结果，但必须解决关键问题，以制定有关预防和治疗 SDB 的临床和公共卫生政策。美国正在发生将改变 SDB 负担的重要时期效应，包括二战后大量出生群体的老龄化、中年期间接触过不同 SDB 危险因素的老年人的生存率提高以及肥胖流行。目前缺乏解决 SDB 在这些新情况下公共卫生负担的数据。本文提出的研究旨在解决对未经治疗的 SDB 负担的理解差距。随着威斯康星州睡眠队列研究（一项针对 SDB 和其他睡眠障碍的纵向研究）的持续 5 年，我们将继续跟踪基线年龄为 30-60 岁的男性和女性社区样本（n = 1522），在延续期间，他们的年龄将达到 55-85 岁。凭借长达 25 年的数据，以及中老年 SDB 和其他因素的数据轨迹，我们将最佳估计未经治疗的 SDB 在临床前和临床明显的心脑血管疾病 (CVD/中风)、认知障碍中的作用和慢性日间功能障碍。我们还将调查与年龄相关的危险因素对睡眠障碍的影响。为了实现这些目标，我们将通过隔夜多导睡眠图、最先进的身体习惯测量（包括 DXA、超声心动图和血管成像、神经心理学测试组和其他测试）进行后续方案，以扩展我们关于 SDB 状态、风险因素、和结果。公共健康相关性：拟议的威斯康星州睡眠队列纵向研究的结果，涉及从中后期向老年过渡的人群中 SDB 的发生和进展，以及 SDB 在发病率和死亡率发展中的作用，将有助于提供所需的新信息了解公共卫生的重要性。研究结果将为临床决策提供信息，包括应确定 SDB 的严重程度、是否应针对亚组进行病例发现，以及减少因错误的 SDB 患者刻板印象而导致的转诊和治疗造成的不平等。研究结果还将为公共卫生政策提供所需的新资源、旨在设定目标的公共计划，以提高对 SDB 的认识，防止 SDB 的发生和发展，并将 SDB 纳入联邦健康促进和监测计划。