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Volume 14 No. 08
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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.

Methods:

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.

Results:

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).

Conclusions:

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.

Citation:

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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