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Paul E. Peppard, PhD; Terry Young, PhD; Mari Palta, PhD; Jerome Dempsey, PhD; James Skatrud, MD

JAMA. 2000;284:3015-3021.

Context  Excess body weight is positively associated with sleep-disordered breathing (SDB), a prevalent condition in the US general population. No large study has been conducted of the longitudinal association between SDB and change in weight.

Objective  To measure the independent longitudinal association between weight change and change in SDB severity.

Design  Population-based, prospective cohort study conducted from July 1989 to January 2000.

Setting and Participants  Six hundred ninety randomly selected employed Wisconsin residents (mean age at baseline, 46 years; 56% male) who were evaluated twice at 4-year intervals for SDB.

Main Outcome Measures  Percentage change in the apnea-hypopnea index (AHI; apnea events + hypopnea events per hour of sleep) and odds of developing moderate-to-severe SDB (defined by an AHI 15 events per hour of sleep), with respect to change in weight.

Results  Relative to stable weight, a 10% weight gain predicted an approximate 32% (95% confidence interval [CI], 20%-45%) increase in the AHI. A 10% weight loss predicted a 26% (95% CI, 18%-34%) decrease in the AHI. A 10% increase in weight predicted a 6-fold (95% CI, 2.2-17.0) increase in the odds of developing moderate-to-severe SDB.

Conclusions  Our data indicate that clinical and public health programs that result in even modest weight control are likely to be effective in managing SDB and reducing new occurrence of SDB.

Author Affiliations: Departments of Preventive Medicine (Drs Peppard, Young, Palta, and Dempsey), Medicine (Dr Skatrud), and Biostatistics and Medical Informatics (Dr Palta), University of Wisconsin School of Medicine, Madison.

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