1055 the Impact of Short Sleep Duration on Instrumental Activities of Daily Living (Iadl) Among Stroke Survivors

Abstract

Supplement, 2017 n=300) is a case control study 1:1 matched by age (±5 years), sex, race and body mass index (BMI±5kg/m 2 ) including those >18 years with paroxysmal AF (PAF) and controls without AF. Participants underwent administration of STOP-Bang, NoSAS (neck circumference, obesity, snoring and sex), Berlin and Epworth Sleepiness Scale (ESS) questionnaires and16-channel research-grade polysomnography. We examined questionnaire diagnostic performance characteristics for moderate to severe OSA (apnea hypopnea index≥15) separately in PAF and without, including area under the curve (AUC, 95% confidence intervals). Analyses were performed in SAS software (version 9.4; Cary, NC). Results: The analytic sample was comprised of 300 participants (n=150 cases and n=150 controls): age 61.9 ± 11.9 years, 63.3% male, and BMI 31.4 ± 6.7 kg/m 2 . Sensitivity for the 4 questionnaires was lower, albeit comparable, in PAF (range: 52-79%) versus controls (range: 61-75%). NoSAS showed highest sensitivity in PAF (79%). Specificity range was overall lower in PAF (43-60%) versus controls (56-80%) The positive predictive value range was lower in PAF (23-27%) versus controls (54-72%). Conversely, the negative predictive value range was higher in PAF (84-89%) versus controls (63-75%). The AUC was lower in PAF versus controls except comparable for STOP-BANG (0.66, 0.56-0.77 versus 0.65, 0.57-0.74) and higher for NoSAS (0.79, 0.72-0.86 versus 0.64, 0.53-0.75) respectively. Conclusion: In this systematic assessment of standard OSA screening instruments, the NoSAS questionnaire performed most optimally in terms of sensitivity and reasonable discriminative ability of moderate to severe OSA detection in those with PAF. Further investigation is needed to identify effective OSA screening strategies with focused efforts on development/refinement of novel OSA screening tools in the AF population. Support (If Any):

The impact of short and long sleep duration on instrumental activities of daily living among stroke survivors

“…An abstract of this paper was presented at the Associated Professional Sleep Societies (APSS) 31st Annual Meeting, June 3–7, 2017, Boston, MA, USA, as a poster presentation with interim findings. The poster’s abstract has been published 24…”