Breathing-Related Sleep Disorders

Prevalence

Obstructive sleep apnea hypopnea is a very common disorder, affecting at least 1%-2% of children, 2%-15% of middle-age adults, and more than 20% of older individuals.
In the general community, prevalence rates of undiagnosed obstructive sleep apnea hypopnea may be very high in elderly individuals.
Since the disorder is strongly associated with obesity, increases in obesity rates are likely to be accompanied by an increased prevalence of this disorder.
Prevalence may be particularly high among males, older adults, and certain racial/ethnic groups.
In adults, the male-to-female ratio of obstructive sleep apnea hypopnea ranges from 2:1 to 4:1.
Gender differences decline in older age, possibly because of an increased prevalence in females after menopause.

Obesity.
Male gender.
Maxillary-mandibular retrognathia or micrognathia.
Positive family history of sleep apnea.
Genetic syndromes that reduce upper airway patency (e.g., Down's syndrome, Treacher Collin's syndrome).
Adenotonsillar hypertrophy (especially in young children).
Menopause (in females).
Various endocrine syndromes (e.g., acromegaly).

Evidence by polysomnography of at least five obstructive apneas or hypopneas per hour of sleep and either of the following sleep symptoms:
1. Nocturnal breathing disturbances: snoring, snorting/gasping, or breathing pauses during sleep.
2. Daytime sleepiness, fatigue, or unrefreshing sleep despite sufficient opportunities to sleep that is not better explained by another mental disorder (including a sleep disorder) and is not attributable to another medical condition.
Evidence by polysomnography of 15 or more obstructive apneas and/or hypopneas per hour of sleep regardless of accompanying symptoms.