Snoring, hypertension, and the sleep apnea syndrome. An epidemiologic survey of middle-aged women.

The lower limit of the prevalence of sleep apnea syndrome (SAS) was estimated among women 40 to 59 years old by a two-stage procedure. In the first stage 2,016 questionnaires were mailed. The response rate was 75.6 percent. Daytime sleepiness was reported by 8.2 percent, habitual snoring by 11.2 percent, and intermittent snoring by 21.7 percent. There were altogether 128 women described with systemic hypertension and these women were more than twice as often habitual snorers. Logistic multiple regression analyses showed almost a threefold increase in the predicted prevalence of hypertension among intermittent and habitual snorers compared with nonsnorers in the age group 40 to 49 years old and a 60 percent increase in the 50- to 59-year-old age group. In the second stage, a group of 97 women highly suspected of SAS were selected because of their habitual snoring and daytime sleepiness. Eventually, 35 of these came for night studies and 14 were found to have SAS. Among the 35 women, 12 were hypertensive and nine of these had SAS. We estimated the lower limit of the prevalence of SAS to be 2.5 percent for women 40 to 59 years old. It is concluded that SAS is a relatively common occurrence among women, especially postmenopausal ones, and it is strongly related to hypertension.