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Volume 14 No. 08
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Accepted Papers

Scientific Investigations

Prevalence and Clinical Significance of Respiratory Effort-Related Arousals in the General Population

Adam Ogna, MD1; Nadia Tobback, RPSGT1; Daniela Andries, RPSGT1; Martin Preisig, MD2; Peter Vollenweider, MD3; Gerard Waeber, MD3; Pedro Marques-Vidal, MD, PhD3; José Haba-Rubio, MD1; Raphaël Heinzer, MD, MPH1
1Center for Investigation and Research in Sleep, Lausanne University Hospital, Lausanne, Switzerland; 2Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland; 3Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland

Study Objectives:

To determine the prevalence and clinical associations of respiratory effort-related arousals (RERA) in a general population sample.


A total of 2,162 participants (51.2% women, 58.5 ± 11.0 years old, body mass index [BMI] 25.6 ± 4.2 kg/m2) of a general population-based cohort (HypnoLaus, Switzerland) underwent full polysomnography at home. Each subject with a RERA index ≥ 5 events/h was compared with an age-, sex- and apnea-hypopnea index (AHI)-matched control without RERA.


A RERA index ≥ 5 events/h was present in 84 participants (3.8%; 95% confidence interval: 3.2–4.8%). In 17 participants (0.8%; 95% confidence interval: 0.5–1.3%), RERAs were the predominant sleep breathing disorder and only one of them complained of excessive daytime sleepiness. Compared to matched controls, subjects with a RERA index ≥ 5 events/h were similar in terms of BMI (26.5 ± 3.5 versus 26.3 ± 4.8 kg/m2, P = .73), neck circumference (38.5 ± 3.3 versus 37.6 ± 3.7 cm, P = .10) and Epworth Sleepiness Scale score (6.7 ± 3.7 versus 6.0 ± 3.7, P = .22). Also, no differences were found for hypertension (21.4% versus 27.4%, P = .47), diabetes (7.1% versus 7.1%, P = 1.00), or metabolic syndrome (31.0% versus 23.8%, P = .39).


In a middle-aged population-based cohort, the prevalence of a RERA index ≥ 5 events/h was low (3.8%) and was not associated with negative clinical outcomes when using the currently recommended scoring criteria of the American Academy of Sleep Medicine.


Ogna A, Tobback N, Andries D, Preisig M, Vollenweider P, Waeber G, Marques-Vidal P, Haba-Rubio J, Heinzer R. Prevalence and clinical significance of respiratory effort-related arousals in the general population. J Clin Sleep Med. 2018;14(8):1339–1345.

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