Factors related to sleep apnea syndrome in sleep clinic patients

Centre Hospitalier Lyon Sud, Lyons, Rhône-Alpes, France
Chest (Impact Factor: 7.48). 07/1994; 105(6):1753-8. DOI: 10.1378/chest.105.6.1753
Source: PubMed


We examined 129 patients recruited from two sleep clinics to study the sleep apnea syndrome (SAS), defined by the apnea-hypopnea index (AHI) > or = 10. Information was registered from a self-administered questionnaire, basal physical measurements, and polysomnography. In 68 subjects recorded for two consecutive nights, a high correlation was found between first- and second-night AHIs (r = 0.89). Habitual loud snoring and breathing arrests during sleep were associated with AHI > or = 10. A model including these two variables, sex, age, and body mass index was created in order to predict AHI > or = 10 and with which it was possible to successfully classify almost three of four patients. Among subjective sleep questionnaire items, only daytime sleepiness was related to drops of transcutaneous oxygen tension. These discrepancies in the observed relationship between sleep parameters and subjective sleep items reduce the questionnaire value in epidemiologic settings where it aimed to detect SAS, as defined solely by the AHI value.

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    • "Among sleep disorders, obstructive sleep apnea syndrome (SAOS) is very common among the older adult [14] [15]. SAOS occurs when there is a repeated obstruction of the upper airway during sleep for 10 s or more, accompanied by oxyhemoglobin desaturation, causing micro-arousals and awakenings . "
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    ABSTRACT: Background and aims: Aging is a multifactorial process that elicits changes in the duration and quality of sleep. Polysomnography is considered to be the standard examination for the analysis of sleep and consists of the simultaneous recording of selected physiological variables during sleep. Objective: The objective of this study was to use polysomnography to compare sleep reported by senior citizens. Methods: We selected 40 patients, both male and female, with ages ranging from 64 to 89 years from the Center for the Study of Aging at the Federal University of São Paulo. Patients answered questions about sleep on the Comprehensive Geriatric Assessment and underwent polysomnography. Results Q2 : The results were compared, and agreement between perceived sleep and poly-somnography was found in several areas. There was an association between difficulty sleeping and sleep onset latency (p ¼ 0.015), waking up at night with sleep onset latency (p ¼0.005), total sleep time with daytime sleepiness (0.005) and snoring (0.027), sleep efficiency with sleepiness (0.004), snoring (0.033) and pause in breathing (p ¼0.024), awakenings with snoring (p ¼0.012) and sleep apnea with pauses in breathing (p =0.001). Conclusion: These results suggest that the older adult population have a good perception of their sleep. The questionnaires aimed at this population should be used as an alternative to polysomnography.
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    • "Therefore, a screening tool is necessary to stratify patients based on their clinical symptoms, their physical examinations, and their risk factors, in order to ascertain patients at high risk and in urgent need of PSG and/or further treatment and patients at low risk who may not need PSG [3]. A number of screening questionnaires and clinical screening models have been developed to help identify patients with OSA [4] [5] [6] [7] [8] [9] [10] [11] [12] [13]. The Berlin questionnaire was developed in 1996 at the Conference on Sleep in Primary Care in Berlin-Germany. "
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    ABSTRACT: Background The increased prevalence of obstructive sleep apnea (OSA) mandates the presence of simple but accurate tools to identify patients with this disorder for early detection and prevention of various serious consequences. This study aimed at comparing four sleep questionnaires as regards their predictive probabilities for OSA.MethodsA cross-sectional study included 234 patients presenting to the sleep clinic. Four sleep questionnaires (Berlin, Epworth Sleepiness Scale [ESS], STOP, and STOP-Bang) were administered to the patients and scoring of the results of the questionnaires was done. Overnight attended polysomnography (PSG) was done for all patients and was considered the gold standard for the diagnosis of OSA. The sensitivity, specificity, positive and negative predictive values of the four questionnaires were calculated.ResultsOf 234 screened patients; 87.1% had OSA, whereas 93.3%, 90.2%, 95.5%, and 68.3% were classified as being at high risk by the Berlin, STOP, STOP-Bang questionnaires and ESS, respectively. The STOP-Bang, Berlin and STOP questionnaires had the highest sensitivity to predict OSA (97.55%, 95.07% and 91.67%, respectively), moderate-to-severe OSA (97.74%, 95.48% and 94.35%, respectively) and severe OSA (98.65%, 97.3% and 95.95%, respectively), but with a very low specificity for OSA patients (26.32%, 25% and 25%, respectively), moderate-to-severe OSA patients (3.7%, 7.41% and 25.93%, respectively) and severe OSA patients (5.36%, 10.71% and 19.64%, respectively), while the ESS had the highest specificity to predict OSA, moderate-to-severe OSA and severe OSA (75%, 48.15% and 46.43%, respectively) but with the lowest sensitivity (72.55%, 75.71% and 79.73%, respectively).Conclusions The sensitivity of Berlin, STOP and STOP-Bang questionnaires was very high yet, the low specificity of these questionnaires results in increased false positives and failure of exclusion of individuals at low risk.
    10/2012; 61(4):433–441. DOI:10.1016/j.ejcdt.2012.07.003
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    • ")where30%(Aberetal.1989), 35%(Bliwiseetal.1991),19%(Chediaketal.1996),33% (Dealbertoetal.1994)subjects,respectively,changedthe classi®cationfollowingasecondevaluation.InOSAHS patients,14%(DeanandChaudhary1992),32%(Mendelson 1994),54%(Lordetal.1991)ofthepatientswerereportedto havechangedtheclassi®cationonasecondevaluationnight. "
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    ABSTRACT: This study was designed to evaluate the variability of the apnoea-hypopnoea index (AHI) in 20 patients with obstructive sleep apnoea-hypopnoea syndrome (OSAHS) and to determine possible relationships of this variability with other polysomnographic parameters. The subjects were recorded on four consecutive nights. The mean AHI values were not significantly altered throughout the four recording nights (P=0.67). The intraclass correlation coefficient of the AHI on the four nights was 0.92. However, the Bland and Altman plot showed that, individually, the AHI presented an important variability, which was not related to its initial value. In regard to the OSAHS severity, 50% of the patients changed the classification from the first to the subsequent nights. Thirteen of the 20 patients (65%) presented a variation in the AHI value equal or higher than 10 events h(-1). When we evaluated the AHI mean values for a specific body position and sleep stage, no difference was observed among the nights. In both supine and lateral-ventral decubitus, higher AHI was observed during Stages 1 and 2 than the other stages. Additionally, the AHI during Stages 1 and 2 and REM sleep was higher on the supine than on the lateral-ventral decubitus. The AHI in OSAHS patients presented a good correlation among the four recording nights; however, a significant individual variability should be considered, especially when AHI is applied in OSAHS classification or as a criterion of therapeutic success.
    Journal of Sleep Research 10/2001; 10(3):245-51. DOI:10.1046/j.1365-2869.2001.00255.x · 3.35 Impact Factor
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