Association of alcohol consumption and sleep disordered breathing in men and women

Paul E Peppard, Diane Austin, Richard L Brown
Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine 2007 April 15, 3 (3): 265-70

STUDY OBJECTIVES: Experimental evidence indicates that alcohol use near bedtime may exacerbate sleep disordered breathing (SDB). However, scarce research has examined the relation between moderate habitual alcohol use and objectively assessed SDB, and it is unclear whether patients with SDB, or those at risk for SDB, should be counseled to avoid alcohol regardless of proximity to bedtime. In this population-based epidemiology study, our objective is to measure the association of SDB with usual alcohol consumption habits.

METHODS: Men (N = 775) and women (N = 645)--initially randomly selected from a working population--participating in the Wisconsin Sleep Cohort Study were evaluated for alcohol consumption and SDB. The apnea-hypopnea index (AHI, events/hour) was determined by in-laboratory polysomnography. AHI > 5 defined "mild or worse" SDB and AHI > 15 defined "moderate or worse" SDB. Alcohol consumption (drinks/day) was assessed by questionnaire. Potential confounding or interacting variables such as smoking, body mass index, and medication use, were measured by clinical assessment and questionnaire.

RESULTS: Relative to men who consumed less alcohol, for each increment of one drink per day, men who consumed more alcohol had 25% greater odds of mild or worse SDB (OR = 1.25, 95% CI = 1.07-1.46, p = 0.006). Among women, minimal to moderate alcohol consumption was not significantly associated with increased risk of SDB.

DISCUSSION: In men, increased usual alcohol consumption was associated with increased risk of mild or worse SDB. Persons with SDB might benefit from generally reduced alcohol consumption and not just avoidance near bedtime.

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