Prevalence and Determinants of Sleep Apnea in the French General Population

Background: Sleep apnea is a frequent disorder and seems to be associated with male sex, age, and obesity but the role of other factors such as poor health behaviors and socio-economic conditions remains unclear. Objectives: To assess the prevalence and determinants of sleep apnea as predicted by the Berlin Questionnaire in the general population. Methods: We analyzed data from participants of the French population-based CONSTANCES cohort, aged 18-69 years, selected in 2013-2015 and screened for sleep apnea in 2017 using Berlin Questionnaire. Information on medical history, health metrics, sociodemographic and lifestyle factors were obtained from inclusion visit and through yearly questionnaires. Weighted analyses were performed in order to provide representative prevalence of the French population. We used adjusted logistic regressions to identify factors associated with sleep apnea, snoring and hypersomnolence. Results: Among 20,151 weighted participants, the prevalence [95% confidence interval] of sleep apnea was 20.9% [20.0;21.9] (22% [20.7;23.4] in men and 17.5% [16.3;18.7] in women) and increased with age. Prevalence of severe snoring was 37.2% [36.1;38.3] while that of hypersomnolence was 14.6% [13.8;15.5]. In multivariable analysis, male sex, age, previous cardiovascular events, smoking, low educational level, low physical activity and depressive symptoms were associated with sleep apnea. Conclusion: Sleep apnea is a public health concern and was estimated to occur in one in five participants in a French population-based cohort. More attention should be given to risk groups such as older adults, people with depressive symptoms and individuals with poorer health behaviors and socioeconomic conditions.