Anne G Wheaton

• PhD
• Epidemiologist at U.S. Department of Health and Human Services

We estimated the prevalence of respiratory symptoms, chronic obstructive pulmonary disease (COPD) risk level, and receipt of a breathing test among adults without reported COPD in 26 states and the District of Columbia by using 2017-2018 Behavioral Risk Factor Surveillance System data. Among adults without reported COPD, the 3 respiratory symptoms...

Introduction/objectives: The Centers for Disease Control and Prevention recognizes routine vaccination, sufficient sleep, and adequate physical activity as behavioral approaches to reduce the incidence of influenza. We aimed to determine the joint national prevalence of these health behaviors among U.S. adults, which has not been reported. Method...

Introduction: Many children and adolescents experience insufficient sleep, which poses risks for their short- and long-term health and development. This study examined the concurrent associations of contextual factors, including child, demographic, neighborhood, and family factors, with short sleep duration. Methods: We combined data on children...

We estimated the prevalence of short sleep duration (<7 hours per day) among US adults aged 18 years or older by using 2020 Behavioral Risk Factor Surveillance System data. Nationally, 33.2% of adults reported short sleep duration. We identified disparities across sociodemographic characteristics, including age, sex, race and ethnicity, marital sta...

We estimated the prevalence of short sleep duration (<8 h/average school night) among high school students (grades 9-12) during the COVID-19 pandemic by using data from the Adolescent Behaviors and Experiences Survey (January-June 2021; N = 7,705). An adjusted logistic regression model predicted prevalence ratios for more difficulty doing schoolwor...

Chronic obstructive pulmonary disease (COPD) accounts for the majority of deaths from chronic lower respiratory diseases, the fourth leading cause of death in the United States in 2019.* COPD mortality rates are decreasing overall. Although rates in men remain higher than those in women, declines have occurred among men but not women (1). To examin...

Background Patients with inflammatory bowel disease (IBD) have higher health services use than those without IBD. We investigated patient and hospital characteristics of major ambulatory surgery encounters for Crohn’s disease (CD) or ulcerative colitis (UC) vs non-IBD patients. Methods We conducted a cross-sectional study using 2017 Nationwide Amb...

Sleep disorder symptoms (trouble falling asleep or staying asleep, unintentionally falling asleep, snoring loudly, and episodes of having stopped breathing) among US adults (N = 59,108) from 8 states and the District of Columbia were analyzed by using data from the 2017 Behavioral Risk Factor Surveillance System. We conducted a multivariable logist...

Objectives To examine the association between chronic obstructive pulmonary disease status and indicators of economic instability and stress to better understand the magnitude of these issues in persons with chronic obstructive pulmonary disease. Methods Analyzed 2017 Behavioral Risk Factor Surveillance System data from 16 states that administered...

Infants, children, and adolescents who do not get sufficient sleep are at increased risk for injuries, obesity, type 2 diabetes, poor mental health, attention and behavior problems, and poor cognitive development (1). The American Academy of Sleep Medicine (AASM) provides age-specific sleep duration recommendations to promote optimal health (1). CD...

Background Epilepsy is associated with a high prevalence of sleep disturbance. However, population-based studies on the burden of sleep disturbance in people with epilepsy are limited. This study assessed sleep duration and sleep quality by epilepsy status in the general U.S. adult population aged ≥ 18 years. Methods We pooled data of cross-sectio...

Background Patients with inflammatory bowel disease (IBD) have a higher risk of hip fracture, but lower likelihood of having arthroplasties than non-IBD patients in Nationwide Inpatient Sample. Little is known about hip fracture-associated hospitalization outcomes.AimsWe assessed the trends in hip fracture hospitalization rates from 2000 to 2017 an...

Objective: To assess the prevalence of migraine or severe headache among US adults by inflammatory bowel disease (IBD) status. Background: Emerging evidence in clinical settings suggests a higher prevalence of migraine among patients with IBD than those without IBD. Methods: Data from 60,436 US adults aged ≥18 years participating in the 2015 a...

Objective-To measure health care utilization among adults with inflammatory bowel disease (IBD) and compare with adults without IBD. Methods-Adults aged 18 and over with IBD (1.2%) and without IBD were identified from the 2015 and 2016 National Health Interview Survey (n = 66,610). This study presents age-adjusted percentages and model-adjusted pre...

The potential for a population at a given location to utilize a health service can be estimated using a newly developed measure called the supply-concentric demand accumulation (SCDA) spatial availability index. Spatial availability is the amount of demand at the given location that can be satisfied by the supply of services at a facility, after di...

Background Among U.S. adults, over 4 million report a history of epilepsy, and more than 15 million report a history of chronic obstructive pulmonary disease (COPD); Chronic obstructive pulmonary disease, which includes chronic bronchitis and emphysema, is a common somatic comorbidity of epilepsy. This study assessed the relationship between self-r...

Introduction Media use, such as television viewing and computer use, has been associated with insufficient sleep among children. Methods Analyses used data collected from parents of children aged 3-17 years via the National Survey of Children’s Health in 2016 and 2017 (N=60,547). The prevalence of age-specific short sleep duration (<10 hours for a...

Introduction Caregiving, providing regular care or assistance to family members or friends with health problems or disabilities, may affect caregivers’ sleep. This study examined self-reported short sleep duration by caregiving status among US adults. Methods Data of 114,496 respondents aged ≥18 years in 19 states, the District of Columbia, and Pu...

Background: Short sleep duration is associated with an increased risk of chronic disease and all-cause death. A better understanding of sleep disparities between people with and without disabilities can help inform interventions designed to improve sleep duration among people with disabilities. Objective: To examine population-based prevalence e...

Crohn's disease and ulcerative colitis, collectively referred to as inflammatory bowel disease (IBD), are conditions characterized by chronic inflammation of the gastrointestinal tract. The incidence and prevalence of IBD is increasing globally, and although the disease has little impact on mortality, the number of older adults with IBD is expected...

Introduction: More than 54 million US adults have arthritis, and more than 15 million US adults have chronic obstructive pulmonary disease (COPD). Arthritis and COPD share many risk factors, such as tobacco use, asthma history, and age. The objective of this study was to assess the relationship between self-reported physician-diagnosed COPD and ar...

Background Previous reports suggest that adults with inflammatory bowel disease (IBD) receive suboptimal preventive care. Aims The population-based study compared the receipt of these services by US adults with and without IBD. Methods Adults aged ≥ 18 years with IBD (1.2%) and without IBD were identified from the 2015 and 2016 National Health In...

Context: Adults with unmet health care needs (UHCN) due to cost have fewer opportunities to receive behavioral counseling in clinical settings, which may be associated with a higher likelihood of having health-risk behaviors. Objective: This study assessed associations between UHCN and health-risk factors. Design/setting: We used 2016 Behavior...

Cigarette smoking is the leading cause of chronic obstructive pulmonary disease (COPD) in the United States; however, an estimated one fourth of adults with COPD have never smoked (1). CDC analyzed state-specific Behavioral Risk Factor Surveillance System (BRFSS) data from 2017, which indicated that, overall among U.S. adults, 6.2% (age-adjusted) r...

A spatially adaptive floating catchment is a circular area that expands outward from a provider location until the estimated demand for services in the nearest population locations exceeds the observed number of health care services performed at the provider location. This new way of creating floating catchments was developed to address the change...

Background Few studies have addressed recent trends in hospitalization costs for inflammatory bowel disease (IBD). Objective We explored trends and described patient and hospital factors associated with hospitalization costs for IBD. Methods Using data from the 2003–2014 National Inpatient Sample for adults aged ≥ 18 years, we estimated costs usi...

Objectives: Insufficient sleep negatively impacts the cardiovascular system. No study has examined the association between sleep duration and heart age (person's predicted vascular age based on cardiovascular disease [CVD] risk profile). This study examines association between sleep duration and excess heart age (EHA; difference between heart age...

Introduction Insufficient sleep negatively impacts the cardiovascular system. Studies have also shown associations between sleep duration and several CVD risk factors. No study has examined the association between sleep duration and heart age (predicted age of a person’s vascular system based on their cardiovascular risk factor profile), a simplifi...

Introduction As the U.S. population ages, there is an increasing burden on individuals to provide regular care or assistance to family members or friends with a health problem or disability. Caregiving may impact sleep health. This study examined short self-reported sleep duration by caregiving status in 12 states. Methods Data from 74,308 respond...

Objectives To assess the association between sleep duration and health-related quality of life (HRQOL) among adults with or without chronic conditions. Methods Using the 2014 Behavioral Risk Factor Surveillance System, we analyzed self-reported data from adult respondents aged ≥18 years with (n = 277,757, unhealthy group) and without (n = 172,052....

Chronic obstructive pulmonary disease (COPD) accounts for the majority of deaths from chronic lower respiratory diseases, the third leading cause of death in the United States in 2015 and the fourth leading cause in 2016.* Major risk factors include tobacco exposure, occupational and environmental exposures, respiratory infections, and genetics.†St...

Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, involves chronic inflammation of the gastrointestinal tract. In 2015, an estimated 3.1 million adults in the United States had ever received a diagnosis of IBD (1). Nationally representative samples of adults with IBD have been unavailable or too small to asses...

Insufficient sleep among children and adolescents is associated with increased risk for obesity, diabetes, injuries, poor mental health, attention and behavior problems, and poor academic performance (1-4). The American Academy of Sleep Medicine has recommended that, for optimal health, children aged 6-12 years should regularly sleep 9-12 hours per...

Introduction Short sleep duration has been linked to an increased risk of injury from drowsy driving or occupational accidents. However, little research has investigated the relationship between sleep duration and injuries resulting from falls. Methods We used data from 291,613 respondents to the 2014 Behavioral Risk Factor Surveillance System sur...

Introduction Current literature shows a bidirectional association between sleep duration and health-related quality of life (HRQOL) among those with chronic diseases such as coronary heart disease (CHD), cancer, chronic obstructive pulmonary disease (COPD), diabetes, or asthma. However, research on the relationship among adults with no history of c...

In 2009, an estimated 565,000 Americans had Crohn's disease (1), an inflammatory bowel disorder that can affect any part of the gastrointestinal tract. Symptoms include persistent diarrhea, abdominal cramps and pain, constipation leading to bowel obstruction, and rectal bleeding.* Symptoms sometimes intensify in severity and require hospitalization...

The American Academy of Sleep Medicine and the Sleep Research Society have determined that adults require ≥7 hours of sleep per day to promote optimal health (1). Short sleep duration (<7 hours per day) has been linked to adverse health outcomes including cardiovascular disease, obesity, diabetes, depression, and anxiety, as well as safety issues r...

Problem/Condition: Persons living in rural areas are recognized as a health disparity population because the prevalence of disease and rate of premature death are higher than for the overall population of the United States. Surveillance data about health-related behaviors are rarely reported by urban-rural status, which makes comparisons difficult...

What is already known about this topic? Crohn’s disease and ulcerative colitis, collectively known as inflammatory bowel disease, are characterized by chronic inflammation of the gastrointestinal tract. Inflammatory bowel disease has been associated with decreased quality of life and extensive morbidity and often results in complications requiring...

Introduction: Five key health-related behaviors for chronic disease prevention are never smoking, getting regular physical activity, consuming no alcohol or only moderate amounts, maintaining a normal body weight, and obtaining daily sufficient sleep. The objective of this study was to estimate the clustering of these 5 health-related behaviors am...

Objective: Racial/ethnic health disparities are infrequently considered by nativity status in the United States, although the immigrant population has practically doubled since 1990. We investigated the modifying role of nativity status (US- vs. foreign-born) on racial/ethnic disparities in short sleep duration (<7 h), which has serious health con...

Background: Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy chang...

Insufficient sleep is common among high school students and has been associated with an increased risk for motor vehicle crashes (1), sports injuries (2), and occupational injuries (3). To evaluate the association between self-reported sleep duration on an average school night and several injury-related risk behaviors (infrequent bicycle helmet use...

Objective: To assess relationships between obstructive lung diseases, respiratory symptoms, and comorbidities by gender. Methods: Data from 12 594 adult respondents to the 2012 South Carolina Behavioral Risk Factor Surveillance System telephone survey were used. Five categories of chronic obstructive airway disease (OAD) were defined: former ast...

To promote optimal health and well-being, adults aged 18-60 years are recommended to sleep at least 7 hours each night (1). Sleeping <7 hours per night is associated with increased risk for obesity, diabetes, high blood pressure, coronary heart disease, stroke, frequent mental distress, and all-cause mortality (2-4). Insufficient sleep impairs cogn...

Introduction: Chronic obstructive pulmonary disease (COPD) is associated with cognitive impairment, but consequences of this association on a person's functional limitations are unclear. We examined the association between COPD and increased confusion and memory loss (ICML) and functional limitations among adults with COPD. Methods: We studied a...

Mental health and sleep are intricately linked. This study characterized associations of psychological distress with short (≤6 hours) and long (≥9 hours) sleep duration among adults aged ≥18 years. 2013 Behavioral Risk Factor Surveillance System data ( n = 36 ,859) from Colorado, Minnesota, Nevada, Tennessee, and Washington included the Kessler 6...

Background: Cigarette smoking and tooth loss are seldom considered concurrently as determinants of chronic obstructive pulmonary disease (COPD). This study examined the multiplicative effect of self-reported tooth loss and cigarette smoking on COPD among US adults aged ≥ 18 years. Methods: Data were from the 2012 Behavioral Risk Factor Surveilla...

Background: Studies have linked adverse childhood experiences (ACE) to harmful health behaviors and the development of chronic diseases in adulthood. However, gender differences have not been comprehensively evaluated in a population-based sample. Methods: Using data from 15,844 women and 10,134 men aged ≥18 years in 4 states of the 2012 Behaviora...

Background: Improving mental health through prevention and increasing public knowledge of how adequate sleep improves health are Healthy People 2020 goals. Serious psychological distress (SPD) is associated with depression, anxiety, and mood disorders. However, it is not known whether SPD is linked to short sleep duration or long sleep duration in...

Unlabelled: The Behavioral Risk Factor Surveillance System (BRFSS) survey is used to estimate chronic obstructive pulmonary disease (COPD) prevalence and could be expanded to describe respiratory symptoms in the general population and to characterize persons with or at high risk for the disease. Tobacco duration and respiratory symptom questions w...

Cigarette smoking is the predominant cause of chronic obstructive pulmonary disease [COPD]. Quitting can prevent development of and complications from COPD. The gold standard in clinician delivery of smoking cessation treatments is the 5As (ask, advise, assess, assist, arrange). This study assessed prevalence and correlates of self-reported receipt...

Adolescents who do not get enough sleep are more likely to be overweight; not engage in daily physical activity; suffer from depressive symptoms; engage in unhealthy risk behaviors such as drinking, smoking tobacco, and using illicit drugs; and perform poorly in school. However, insufficient sleep is common among high school students, with less tha...

Little is known about trends in prescriptions for benzodiazepines among patients with chronic obstructive pulmonary disease (COPD). Our objective was to examine trends of office/outpatient department visits with a mention of a benzodiazepine made by patients aged ≥40 years with COPD in the United States. We used data from the National Ambulatory Me...

Background The purpose of this study was to assess the relationship of smoking duration with respiratory symptoms and history of chronic obstructive pulmonary disease (COPD) in the South Carolina Behavioral Risk Factor Surveillance System survey in 2012. Methods Data from 4,135 adults aged ≥45 years with a smoking history were analyzed using multi...

This study aims to assess the relationship of body mass index (BMI) status with respiratory conditions, asthma, and chronic obstructive pulmonary disease (COPD) in a state population. Self-reported data from 11,868 adults aged ≥18 years in the 2012 South Carolina Behavioral Risk Factor Surveillance System telephone survey were analyzed using multiv...

Chronic obstructive pulmonary disease (COPD) is a group of progressive respiratory conditions, including emphysema and chronic bronchitis, characterized by airflow obstruction and symptoms such as shortness of breath, chronic cough, and sputum production. COPD is an important contributor to mortality and disability in the United States. Healthy Peo...

Objective: To characterize the prevalence of chronic obstructive pulmonary disease (COPD) among residential care facility (RCF) residents in the United States, and to compare patterns of hospital visits and comorbidities with residents without COPD. Method: Resident data from the 2010 National Survey of Residential Care Facilities were analyzed. Me...

Background: The question of how smoking, COPD, and other chronic diseases are related remains unresolved. Therefore, we examined relationships between smoking, COPD, and 10 other chronic diseases and assessed the prevalence of co-morbid chronic conditions among people with COPD. Methods: We analyzed cross-sectional data from 405,856 US adults ag...

Study Objective: To examine recent national trends in outpatient visits for sleep related difficulties in the United States and prescriptions for sleep medications. Design: Trend analysis. Setting: Data from the National Ambulatory Medical Care Survey from 1999 to 2010. Participants: Patients age 20 y or older. Measurements and Results: The num...

Findings in published reports have suggested that drowsy driving is a factor each year in as many as 7,500 fatal motor vehicle crashes (approximately 25%) in the United States. CDC previously reported that, in 2009-2010, 4.2% of adult respondents in 19 states and the District of Columbia reported having fallen asleep while driving at least once dur...

Introduction: Cigarette smoking is a major cause of chronic obstructive pulmonary disease, (COPD) but many persons with COPD continue to smoke. Quitting can help prevent the development of and complications from COPD. This study examined whether smoking and cessation behaviors differed among adults with a) COPD, b) asthma, c) other chronic conditi...

Although short sleep duration is related to chronic conditions, such as hypertension, diabetes and obesity, the association with stroke is less well known. Using 2006–2011 National Health Interview Surveys, we assessed the association between self-reported duration of sleep and prevalence of stroke stratifying by age and sex. Of the 154 599 partici...

The extent to which patients with COPD are receiving indicated treatment with medications to improve lung function and recent trends in the use of these medications is not well documented in the United States. The objective of this study was to examine trends in prescription medications for COPD among adults in the United States from 1999 to 2010....

A variety of small-area statistical models have been developed for health surveys, but none are sufficiently flexible to generate small-area estimates (SAEs) to meet data needs at different geographic levels. We developed a multilevel logistic model with both state- and nested county-level random effects for chronic obstructive pulmonary disease (C...

Abstract Recent trends in prescriptions for medicines used to treat chronic obstructive pulmonary disease (COPD) in the United States have received little attention. Our objective was to examine trends in prescribing practices for medications used to treat COPD. We examined data from surveys of national samples of office visits to non-federal emplo...

Objective: To examine the form of the relationship between sleep duration and anthropometric measures and possible differences in these relationships by gender and race or ethnicity. Design and methods: Data for 13,742 participants aged ≥20 years from the National Health and Nutrition Examination Survey 2005-2010 were used. Sleep duration was ca...

Purpose To assess associations among chronic obstructive pulmonary disease (COPD), disability as measured by activities of daily living (ADL) and instrumental ADL (IADL), engagement in social activities, and death among elderly noninstitutionalized US residents. Materials and methods A nationally representative sample of 9,415 adults who were aged...

National reports on COPD have been limited to non-Hispanic white, non-Hispanic black, and Hispanic adults because of insufficient numbers of American Indians and Asians in national surveillance systems. We analyzed self-reported COPD prevalence for adults aged >=25 years from BRFSS, Medicare hospital claims for first-listed COPD diagnosis for ages...

There is limited information from population-based investigations of the associations between sleep duration and sleep disorders and parameters of glucose homeostasis. The objective of the present study was to examine cross-sectional associations between sleep duration and sleep disordered breathing with concentrations of insulin, fasting and 2-hou...

To examine the effects of obesity and frequent mental distress (FMD) on the relationship of sleep duration with coronary heart disease (CHD), stroke, and diabetes. Cross-sectional study. Population-based surveillance. There were 54,269 adults age 45 y or older who completed the 2010 Behavioral Risk Factor Surveillance System survey in 14 states. Ne...

We examined the association of impaired lung function and respiratory symptoms with measures of health status and health-related quality of life (HRQOL) among US adults. The sample included 5139 participants aged 40--79 years in the National Health and Nutrition Examination Survey 2007--2010 who underwent spirometric testing and responded to questi...

To determine if self-reported sleep duration was associated with weight-control behaviors among US high school students. National Youth Risk Behavior Survey. United States, 2007. US high school students (N = 12,087). Students were asked if they had engaged in several weight-control behaviors during the 30 days before the survey to lose or maintain...

Background: National spirometric surveillance data in the United States were last collected during 1988-1994. The objective of this study was to provide current estimates for obstructive and restrictive impairment of lung function and to examine changes since 1988-1994. Methods: We used data from 14,360 participants aged 20 to 79 years from the...

BACKGROUND: This report updates surveillance results for chronic obstructive pulmonary disease (COPD) in the United States. METHODS: For 1999 to 2011, data from national data systems for adults aged ≥25 years were analyzed. RESULTS: In 2011, 6.5% of adults (∼13.7 million) reported having been diagnosed with COPD. From 1999 to 2011, the overall age-...

Objective: This investigation examined the association of anxiety or depressive disorder and frequent insufficient sleep. Methods: Data were obtained from a 2010 telephone survey of a population-based sample of 113,936 adults in 20 states. Respondents were asked how often they did not get enough rest or sleep and if they had ever received a diag...

Morbidity and Mortality Weekly Report MMWR. 2013;51/52:1033-1037. 2 tables omitted. Available at http://www.cdc.gov/MMWr/pdf/wk/mm6151.pdf According to the National Highway Traffic Safety Administration (NHTSA), 2.5% of fatal motor vehicle crashes (approximately 730 in 2009) and 2.0% of all crashes with nonfatal injuries (approximately 30,000 in 20...

Background Although evidence suggests that poor sleep is associated with chronic disease, little research has been conducted to assess the relationships between insufficient sleep, frequent mental distress (FMD ≥14 days during the past 30 days), obesity, and chronic disease including diabetes mellitus, coronary heart disease, stroke, high blood pre...

he National Highway Traffic Safety Administration (NHTSA) reports that 2.5% of fatal motor vehicle crashes (approximately 730 in 2009) and 2.0% of all crashes with nonfatal injuries (approximately 30,000 in 2009) involved drowsy driving. Data collection methods make it challenging to estimate the number of crashes that involve drowsy drivers, but s...

Background Although adverse childhood experiences (ACEs) have previously been demonstrated to be adversely associated with a variety of health outcomes in adulthood, their specific association with sleep among adults has not been examined. To better address this issue, this study examines the relationship between eight self-reported ACEs and freque...

The Centers for Disease Control and Prevention (CDC) has long recognized that its major constituents, the state and local health departments, have the primary role for targeting resources and efforts to prevent and control disease. However, state and local level information about disease burden may be more relevant to local and state decision-maker...

Background Reasons for the excess risk for cardiovascular disease among people with chronic obstructive pulmonary disease remain unclear. Our objective was to examine the cardiovascular risk profile for adults with obstructive and restrictive impairments of lung functioning in a representative sample of adults from the United States. Methods We us...

Table S1. Age-adjusted means and percentages (standard error) of sociodemographic and cardiovascular factors among 6816 U.S. adults aged 20-79 years, by categories of respiratory impairment based on postbronchodilator data, National Health and Nutrition Examination Survey 2007-2010. Table S2. Adjusted* prevalence ratios (95% confidence interval) fo...

Chronic obstructive pulmonary disease (COPD) is a group of progressive, debilitating respiratory conditions, including emphysema and chronic bronchitis, characterized by difficulty breathing, lung airflow limitations, cough, and other symptoms. COPD often is associated with a history of cigarette smoking and is the primary contributor to mortality...

Objective: To examine associations of impaired lung function with measures of health status and health-related quality of life (HRQOL) among U.S. adults. Methods: We used data from participants aged 40-79 years of the National Health and Nutrition Examination Survey 2007-2008 who underwent spirometric testing and responded to questions about health...

SESSION TYPE: COPD: OutcomesPRESENTED ON: Wednesday, October 24, 2012 at 02:45 PM - 04:15 PMPURPOSE: Chronic obstructive pulmonary disease (COPD) is the third leading cause of U.S. deaths. Demographic disparities in COPD mortality are well recognized yet research is limited about geographic disparities. We explore geographic disparities at state an...

Background: Over 12 million Americans currently live with chronic obstructive pulmonary disease (COPD). It is a significant cause of hospitalization and negatively affects quality of life. Little is known about how COPD contributes to functional impairment among adults in the general population. Objective: To examine associations between COPD and...

To determine if symptoms of sleep disordered breathing (SDB) are associated with depression symptomology in a national sample. National Health and Nutrition Examination Survey. U.S., 2005-2008. 9,714 adults (≥ 18 years). Respondents were asked about frequency of snoring and snorting, gasping, or stopping breathing while asleep and completed the PHQ...