2012Obstructive sleep apnea is common among patients referred for coronary artery bypass grafting and can be diagnosed by portable monitoring CORONARY ARTERY DISEASE, PHILADELPHIA, v. 23, n. 1, supl. 2, Part 3, pp. 31-38, JAN, 2012 http://www.producao.usp.br/handle/BDPI/32565
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Outros departamentos -FM/Outros Comunicações em Eventos -FM/OutrosObstructive sleep apnea is common among patients referred for coronary artery bypass grafting and can be diagnosed by portable monitoring Background Obstructive sleep apnea (OSA) is common among patients with coronary artery disease. However, OSA remains largely under recognized. The lack of clinical suspicion and difficulties to access full polysomnography (PSG) are limiting factors. The aim of this study was to evaluate, among patients referred to coronary artery bypass grafting (CABG): (i) the prevalence of OSA, (ii) the association of OSA with clinical symptoms, (iii) the performance of overnight unattended portable monitoring (PM) as an alternative method for the diagnosis of OSA.Methods Consecutive patients referred for CABG were evaluated by standard physical evaluation and validated questionnaires (Berlin questionnaire and Epworth Sleepiness Scale) and underwent full PSG and PM (Stardust II).
ResultsWe studied 70 consecutive patients (76% men), age 58 ± 7 years (mean ± SD), BMI [median (interquartile range)] 27.6 kg/m 2 (25.8-31.1). The prevalence of OSA (full PSG) using an apnea-hypopnea index of at least 5 events/h was 87%. Commonly used clinical traits for the screening of OSA such as the Epworth Sleepiness Scale and neck circumference had low sensitivities to detect OSA. In contrast, the Berlin questionnaire showed a good sensitivity (72%) to detect OSA. PM showed good sensitivity (92%) and specificity (67%) for the diagnosis of OSA.Conclusion OSA is strikingly common among patients referred for CABG. The Berlin questionnaire, but not symptom of excessive daytime sleepiness is a useful tool to screen OSA. PM is useful for the diagnosis of OSA and therefore is an attractive tool for widespread use among patients with coronary artery disease.
IntroductionObstructive sleep apnea (OSA) is characterized by repeated episodes of partial or complete upper airway obstruction during sleep, and is associated with recurrent hypoxemia and arousals [1]. OSA is a public health problem with a prevalence ranging from 4 to 25% in the general population [2,3]. OSA is tightly linked to cardiovascular disease, and the prevalence of OSA is much higher in patients with established cardiovascular disease [4], such as hypertension [5,6], atrial fibrillation [7], and hypertrophic cardiomyopathy [8]. The estimated prevalence of OSA among patients with coronary artery disease (CAD) ranges from 40 to 45% [9][10][11][12][13]. Therefore, patients referred to coronary artery bypass grafting (CABG) may present a high prevalence of OSA. The recognition of...
