Screening for obstructive sleep apnea/hypopnea syndrome: Subjective and objective factors

Friedman, Michael; Wilson, Meghan N.; Pulver, Tanya; Pandya, Hemang K.; Joseph, Ninos J.; Lin, Huang‐Chi; Chang, Hung‐Wen

doi:10.1016/j.otohns.2009.12.038

Cited by 39 publications

(29 citation statements)

References 7 publications

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“…33 Our review identified nineteen studies that evaluated the performance of the Berlin Questionnaire against PSG in the identification of patients with OSA. [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] The studies were conducted in a wide variety of geographic locations including Brazil, 38 Canada, 34,42 Greece, 37 Iran, 36 Korea, 40 Turkey, 43 and the United States. 41,44 Various patient populations were considered, including those in primary care clinics, sleep clinics, the veteran population, and patients with cardiac disease.…”

Section: Discussionmentioning

confidence: 99%

“…In a sample of individuals suspected to have OSA, the sensitivity of the OSAS score was 0.86 (95% CI: 0.80 to 0.91) against PSG at an AHI > 5 cut = off, however; specificity was lower at 0.47 (95% CI: 0.34 to 0.56) with a high number of false positives in the low-risk group 39 (see supplemental material, Table S35). One study evaluating the performance of the Kushida Index against PSG showed a high sensitivity of 0.98 (95% CI: 0.95 to 0.99) and high specificity of 1.00 (95% CI: 0.92 to 1.00) to detect AHI ≥ 5 (see supplemental material, Table S36).…”

Section: Multivariable Apnea Prediction Questionnairementioning

confidence: 99%

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Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Kapur

Auckley

Chowdhuri

et al. 2017

Journal of Clinical Sleep Medicine

2,037

1,498

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Introduction: This guideline establishes clinical practice recommendations for the diagnosis of obstructive sleep apnea (OSA) in adults and is intended for use in conjunction with other American Academy of Sleep Medicine (AASM) guidelines on the evaluation and treatment of sleep-disordered breathing in adults. Methods: The AASM commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence. The task force developed recommendations and assigned strengths based on the quality of evidence, the balance of benefits and harms, patient values and preferences, and resource use. In addition, the task force adopted foundational recommendations from prior guidelines as "good practice statements", that establish the basis for appropriate and effective diagnosis of OSA. The AASM Board of Directors approved the final recommendations. Recommendations:The following recommendations are intended as a guide for clinicians diagnosing OSA in adults. Under GRADE, a STRONG recommendation is one that clinicians should follow under most circumstances. A WEAK recommendation reflects a lower degree of certainty regarding the outcome and appropriateness of the patient-care strategy for all patients. The ultimate judgment regarding propriety of any specific care must be made by the clinician in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options, and resources. Good Practice Statements:Diagnostic testing for OSA should be performed in conjunction with a comprehensive sleep evaluation and adequate follow-up. Polysomnography is the standard diagnostic test for the diagnosis of OSA in adult patients in whom there is a concern for OSA based on a comprehensive sleep evaluation. Recommendations:1. We recommend that clinical tools, questionnaires and prediction algorithms not be used to diagnose OSA in adults, in the absence of polysomnography or home sleep apnea testing. (STRONG) 2. We recommend that polysomnography, or home sleep apnea testing with a technically adequate device, be used for the diagnosis of OSA in uncomplicated adult patients presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA. (STRONG) 3. We recommend that if a single home sleep apnea test is negative, inconclusive, or technically inadequate, polysomnography be performed for the diagnosis of OSA. (STRONG) 4. We recommend that polysomnography, rather than home sleep apnea testing, be used for the diagnosis of OSA in patients with significant cardiorespiratory disease, potential respiratory muscle weakness due to neuromuscular condition, awake hypoventilation or suspicion of sleep related hypoventilation, chronic opioid medication use, history of stroke or severe insomnia. (STRONG) 5. We suggest that, if clinically appropriate, a split-night diagnostic protocol, rather than a full-night diagnostic protoc...

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Section: Discussionmentioning

confidence: 99%

Section: Multivariable Apnea Prediction Questionnairementioning

confidence: 99%

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Kapur

Auckley

Chowdhuri

et al. 2017

Journal of Clinical Sleep Medicine

2,037

1,498

View full text Add to dashboard Cite

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“…The PSGs were performed according to commonly accepted clinical standards. 15,16 The montage included encephalogram leads O1A2, O2A1, C1A2, C2A1, F1A2, F2A1; electromyogram leads for left eye, right eye, submentalis, and leg (left and right separately), electrocardiogram, and respiratory status measures by nasal airflow (nasal air pressure) and oronasal airflow (thermistor, used for backup), rib cage and abdominal respiratory effort (respiratory impedance plethysmographs), and pulse oximetry. Sleep scoring was done in 30-sec epochs according to the system of Rechtschaffen and Kales, 17 as modified by the 2007 AASM scoring manual.…”

Section: Polysomnographymentioning

confidence: 99%

Obstructive Sleep Apnea in Patients with End-Stage Lung Disease

Romem

Iacono²,

McIlmoyle³

et al. 2013

Journal of Clinical Sleep Medicine

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Objectives:Little is known about the rate of obstructive sleep apnea (OSA) in patients with end stage lung disease (ESLD). Given the potential deleterious effect of OSA in these patients, we assessed the case-rate and severity of OSA and described associated patient characteristics. Methods: Retrospective survey of 60 patients with ESLD referred for lung transplantation evaluation. Demographic, polysomnographic, spirometric, and medication utilization data were extracted and analyzed. Results: As demographic and polysomnographic data did not differ between obstructive and restrictive patients, we present analysis of pooled data. Demographics/physiology: median age was 58.5 years, 52% males, mean BMI 32.3 kg/m 2 , 52% obstructive. Sleep variables (all medians): total sleep time (TST) 312 min, sleep effi ciency 77%, minimal oxygen saturation 84%, apnea hypopnea (AHI) 9.7, respiratory disturbance index (RDI) 12.7 events/h of sleep. Sixty-seven percent had RDI > 5; 21% had RDI between 15 and 30; and 21% had RDI > 30. Periodic limb movement index ≥ 15/h sleep was present in 21.7%. An independent positive correlation between DLCO% and RDI was noted (r = 0.41, p < 0.01). The minimal oxygen saturation was negatively correlated with the RDI (r = -0.34, p < 0.01). The use of ACE inhibitors was associated with moderate-to-severe OSA (odd ratio of 4.67, CI 1.45-15.03; p = 0.017). Conclusions:In patients with ESLD, organic sleep disorders are common. Greater severity of OSA was associated with the higher DLCO% and lower oxygen saturation. keywords: End-stage lung disease, sleep apnea, obstructive lung disease, restrictive lung disease, diffusion capacity, lung transplantation, sleep disorders, oxygen saturation Citation: Romem A; Iacono A; McIlmoyle E; Patel KP; Reed RM; Verceles AC; Scharf SM. Obstructive sleep apnea in patients with end-stage lung disease. J Clin Sleep Med 2013;9(7):687-693.

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“…При этом, если само отчеты о храпе могут быть достаточно надежными, то данные об остановках дыхания во сне, повиди мому, менее точны и нуждаются в дополнительной верификации [15]. Вместе с тем, настоящее исследо вание и его результаты отвечают задачам скрининга и позволяют определить перспективные направления для дальнейших изысканий.…”

Section: Discussionunclassified

Relationship of Sleep-Disordered Breathing, Emotional Complaints and Antropometric Measurements (The Results of Screening Survey Among Saint-Petersburg Citizens)

Дубинина¹,

Korostovtseva²,

Rotar³

et al. 2015

Ross. kardiol. ž.

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Цель. Оценка распространенности нарушений дыхания во сне (НДС), их сопряженности с эмоциональными жалобами, антропометрическими характе-ристиками и характеристиками образа жизни в репрезентативной выборке жителей крупного мегаполиса (Санкт-Петербурга). Материал и методы. С использованием структурированного интервью и методов антропометрии было обследовано 358 жителей Санкт-Петербурга в возрасте 21-68 лет. Оценивались наличие/отсутствие и частота проявлений диссомнических явлений и НДС (храпа, остановок дыхания во сне), эмоцио-нальные жалобы, индекс массы тела, характеристики образа жизни. 21,5% респондентов затруднились ответить на вопрос о качестве дыхания во сне, из них большую часть составили женщины (25,9% против 14,2% p<0,05). В итоге были проанализированы данные 281 респондента -115 мужчин и 166 женщин. Результаты. Наличие регулярного храпа отмечают 29,6% мужчин и 22,9% женщин. Пропорциональное увеличение частоты храпа с возрастом отме-чалось только среди женщин (r=0,21, p<0,01). О наличии эпизодов апноэ сообщают 14,3% респондентов. Отчетливых различий по данному параме-тру между мужчинами и женщинами и в разных возрастных группах не выявлено. Вне зависимости от пола и возраста частота храпа была связана с индикаторами ожирения: индексом массы тела (r=0,26; p<0,001) и окружностью талии (r=0,24; p<0,001). Зависимости между частотой апноэ и индикаторами ожирения обнаружено не было. Была выявлена связь частоты храпа с уровнем сонливости (r=0,21, p=0,001), выраженно-стью эмоциональной напряженности (r=0,24, p<0,001) и подавленности (r=0,20, p<0,01), частотой эпизодов бруксизма (r=0,18, p<0,01) и пробу-ждений с ощущением удушья / тяжести в груди (r=0,17, p<0,01). Частота апноэ коррелировала с типичностью чувства усталости после ночного сна (r=0,16, p<0,01), частотой пробуждений с ощущением удушья/тяжести в груди (r=0,17, p<0,01), а также частотой эпизодов бруксизма (r=0,16, p=0,01). Отчетливой сопряженности НДС и характеристик образа жизни выявлено не было. Заключение. У каждого четвертого взрослого жителя Санкт-Петербурга выявляются НДС, которые связаны с общим снижением качества сна, дис-сомническими и эмоциональными жалобами, а также с показателями ожи-рения. RELATIONSHIP OF SLEEP-DISORDERED BREATHING, EMOTIONAL COMPLAINTS AND ANTROPOMETRIC MEASUREMENTS (THE RESULTS OF SCREENING SURVEY AMONG SAINT-PETERSBURG CITIZENS)Dubinina E. A. Aim. To assess the prevalence of sleep-disordered breathing (SDB), their relation to emotional complaints, antropometric measures and life-style factors in representative cohort of a large city inhabitants (Saint-Petersburg). Material and methods. Using structured interview and antropometric methods we studied 358 citizens of Saint-Petersburg at the age of 21-68 y. o. The presence/absence of the following were evaluated: dyssomnias, SDB (snore, breathing pauses), emotional complaints, body mass index, life-style characteristics. 21,5% of respondents could not respond definitely about the sleep breathing quality, of those mostly women (25,9% vs 14,2%; p<0,05). Finally we analyze...

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Screening for obstructive sleep apnea/hypopnea syndrome: Subjective and objective factors

Cited by 39 publications

References 7 publications

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Obstructive Sleep Apnea in Patients with End-Stage Lung Disease

Relationship of Sleep-Disordered Breathing, Emotional Complaints and Antropometric Measurements (The Results of Screening Survey Among Saint-Petersburg Citizens)

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