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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    • "Although BQ seems to be a valid tool to detect OSA in the general population, in the clinical sleep setting the literature is inconsistent. Supporting the use of the BQ, some studies reported that BQ can serve as a valid and useful screening method to detect OSA in the clinical sleep setting (Amra et al., 2013; Dealberto et al., 1994) and in general populations (Kang et al., 2013; Saleh et al., 2011). "
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    ABSTRACT: Introduction: The Berlin questionnaire (BQ) is a common tool to screen for Obstructive Sleep Apnea (OSA) in the general population, but its application in the clinical sleep setting is still challenging. The aim of this study was to determine the specificity and sensitivity of the BQ compared to the apnea-hypopnea index obtained from polysomnography recordings obtained from a sleep clinic in Iran. Methods: We recruited 100 patients who were referred to the Sleep Disorders Research Center of Kermanshah University of Medical Sciences for the evaluation of suspected sleep-disorder breathing difficulties. Patients completed a Persian version of BQ and underwent one night of PSG. For each patient, Apnea-Hypopnea Index (AHI) was calculated to assess the diagnosis and severity of OSA. Severity of OSA was categorized as mild when AHI was between 5 and 15, moderate when it was between 15 and 30, and severe when it was more than 30. Results: BQ results categorized 65% of our patients as high risk and 35% as low risk for OSA. The sensitivity and the specificity of BQ for OSA diagnosis with AHI>5 were 77.3% and 23.1%, respectively. Positive predictive value was 68.0% and negative predictive value was 22.0%. Moreover, the area under curve was 0.53 (95% CI: 0.49-0.67, P=0.38). Discussion: Our findings suggested that BQ, despite its advantages in the general population, is not a precise tool to determine the risk of sleep apnea in the clinical setting, particularly in the sleep clinic population.
    Full-text · Article · Jan 2016 · Basic and Clinical Neuroscience
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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.
    Full-text · Article · Jul 2015 · Sleep Science
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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.
    Full-text · Article · Oct 2012
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