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The Sleep Heart Health Study

Anne B. Newman, MD, MPH; Greg Foster, MA; Rachel Givelber, MD; F. Javier Nieto, MD, PhD; Susan Redline, MD; Terry Young, PhD

Arch Intern Med. 2005;165:2408-2413.

Background  The relationship of weight changes to the incidence, progression, and remission of sleep-disordered breathing (SDB) is not well defined. This study aims to determine the relationship between change in weight and progression or remission of SDB by polysomnography.

Methods  We performed a longitudinal cohort study of the cardiovascular consequences of sleep apnea in diverse US communities. Sleep apnea and polysomnographic indicators of SDB were assessed 5 years apart.

Results  A total of 2968 men and women (mean age, 62 years) participated in the study. Men were more likely to have an increase in Respiratory Disturbance Index (RDI) with a given increase in weight than were women, and this was not explained by differences in starting weight, waist circumference, age, or ethnicity. In a linear regression analysis, both men and women had a greater increase in RDI with weight gain than a decrease in RDI with weight loss. In a categorical analysis of larger degrees of change, this sex difference was also evident. Associations were similar in diverse ethnic groups. However, SDB progressed over time, even in those with stable weight.

Conclusion  Modest changes in weight were related to an increase or decrease in SDB, and this association was stronger in men than in women.

Author Affiliations: Department of Epidemiology and Medicine, University of Pittsburgh, Pittsburgh, Pa (Drs Newman and Givelber); Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Md (Mr Foster); Department of Population Health Sciences, University of Wisconsin, Madison (Drs Nieto and Young); and Department of Medicine, Case Western Reserve University, Cleveland, Ohio (Dr Redline). Mr Foster is currently with MedStar Research Institute, Hyattsville, Md.

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