![]() In the Rotterdam Scan Study, 13 which included follow-up for 4.2 years, brain magnetic resonance imaging (MRI) analysis was performed on 1,077 healthy adults aged 60 to 90 years without dementia the results showed that the prevalence of symptomatic CVD was 5 times as high in people with silent cerebrovascular lesions as in those not so affected. 5, 10, 12 On the other hand, it has been suggested that the presence of silent cerebrovascular lesions is the preconditioning phase of CVD from the viewpoint of preventive medicine. 9 Also, it has been reported that the more severe the OSA, the higher the risk of CVD development. 12 Furthermore, accumulating evidence suggests that OSA severity correlates with the development of CVD. 9 In fact, OSA was identified as a risk factor for CVD independent of other risk factors, such as hypertension. The results revealed that subjects with an AHI of more than 11.0/h had a significantly higher prevalence of CVD, coronary heart disease, and heart failure than those with an AHI of 0 to 1.3/h. 9 – 11 The Sleep Heart Health Study, conducted in 2001 in the USA, involved performing polysomnography (PSG) on 6,424 healthy subjects aged over 40 years. Obstructive sleep apnea (OSA) might also increase morbidity and mortality related to ischemic heart failure, arrhythmia, and cerebrovascular disease (CVD). Sleep fragmentation associated with nocturnal respiratory events and hypoxia adversely affects various physiological functions such as those of the respiratory, cardiovascular, and endocrine systems as well as mental function. All Japanese people may be at risk for OSAS. 8 As causal factors, the craniomandibular factors 7 have been suggested. 6 In addition, concomitance of obesity with OSAS is less frequent in Asians, 7 and in this population OSAS becomes severe despite mild obesity. 5 Asians have higher morbidity from severe OSAS than Caucasians. When the coexistence of excessive daytime sleepiness was defined as OSAS, OSAS was prevalent in 4.5% of males and 3.2% of females. 4 In Asian countries, on the other hand, a survey of Korean middle-aged or senior residents showed that sleep disordered breathing in those with an AHI ≥ 5/h was prevalent in 27% of males and 16% of females. Among subjects with an AHI < 5/h, moderate sleep disordered breathing was found in 7.5% while mildly to moderate sleep disordered breathing was found in 16%. reported a 5-year follow-up survey on the population in the Cleveland Family Study. 1, 2 Prevalence estimates from studies with probability samples range for obstructive sleep apnea syndrome (OSAS) of at least mild severity as defined by apnea-hypopnea index (AHI) ≥ 5/h, from 3% to 28% for OSAS of at least moderate severity defined by AHI ≥ 15/h, estimates range from 1% to 14%. The prevalence of sleep disordered breathing among middle-aged adults was reported to be 4% in men and 2% in women in the cross-sectional survey of the Wisconsin Sleep Cohort Study.
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