Longitudinal Study of Sleep-Disordered Breathing Consequences: The Wisconsin Sleep Cohort Study Sleep disordered breathing (SDB), is widely recognized as a highly prevalent but under-diagnosed condition that may have a causal role in hypertension, cardiovascular and cerebrovascular disease, hypersornnolence, and decrements in daytime functioning. However, findings thus far do not provide a sufficient basis for determining rational clinical and public health responses to the high prevalence. The long-term objective of this project is to determine the magnitude of morbidity and mortality attributable to SDB that could potentially be reduced with prevention or treatment of SDB. Because SDB is a chronic condition with a wide severity spectrum and the hypothesized health effects likely take years to develop, longitudinal data from population samples are essential. Furthermore, occurrence of SDB is high in middle age, but the hypothesized long-term outcomes are conditions primarily realized in older age (>60 years), necessitating longitudinal data on individuals as they transition from middle to older age in order to validly estimate the morbidity risks attributable to SDB. Currently these data are lacking; the research proposed here was designed to address the gap in understanding the burden of undiagnosed SDB in adults. With 5-year continuation of the present longitudinal study of SDB, the Wisconsin Sleep Cohort Study, (WSCS) we propose to investigate the role of SDB as a determinant and correlate of oreclinical cardiovascular and cerebrovascular disease (CVD/stroke), incident CVD/stroke, mortality and in chronic daytime dysfunction. We will also investigate changes in SDB occurrence and its effects with aging from middle to older age. To achieve these goals we will conduct follow-up exams to conduct the following tests for preclinical CVD/stroke: 24 hour ambulatory blood pressure, ankle-brachial systolic blood pressure index, carotid intima-media thickness, exercise treadmill test, and ECG. We will also perform polysomnography, in addition to the follow-up exams, on a subsample of 500 men and women who will transition from middle to older age (>60 years) during the 5 years of the proposed study. All minority participants (n = 83) enrolled in the WSC will be recruited for both exams, regardless of age. With prospective analyses, will assess the independent contribution of SDB to preclinical and overt CVD/stroke, hypersonmolence, cognitive function, occupational injury, depression and quality of life. These findings will be of direct use in: clinical guidelines of what SDB level of severity and symptoms should be treated, whether subgroups at high risk for SDB should be targeted for case finding and intervention, and justify inclusion of SDB in federal and other surveillance and health promotion programs. ? ?
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