Sunil Sharma1, Umer Mukhtar2, Colleen Kelly3, Paul Mather4, Stuart F Quan5. 1. Division of Pulmonary and Critical Care, Einstein Medical Center, Philadelphia, Pa; Sidney Kimmel Medical College, Philadelphia, Pa. Electronic address: sharmasu@einstein.edu. 2. Division of Pulmonary and Critical Care, Einstein Medical Center, Philadelphia, Pa. 3. Kelly Statistical Consulting, San Diego, Calif. 4. Heart Failure-Transplant Program, University of Pennsylvania, Philadelphia. 5. Division of Sleep Medicine, Harvard Medical School, Boston, Mass; Arizona Respiratory Center, University of Arizona College of Medicine, Tucson.
Abstract
PURPOSE: Sleep-disordered breathing is a common sleep disorder. Recent studies have shown that hospitalized obese patients have a high likelihood of unrecognized sleep-disordered breathing. However, no systematic large study has so far evaluated the outcomes of a screening program. This study provides demographic, clinical, and outcome data from a screening program at a tertiary care academic center. METHODS: Subjects were 5062 patients screened from March 2013 to July 2016. Of these, 1410 underwent in-hospital overnight high-resolution pulse oximetry and 680 underwent polysomnography post discharge. Patients placed on positive airway therapy were followed in an ambulatory setting. RESULTS: The mean age was 60.7 years (SD 15.2), and mean body mass index was 34.8 kg/m2 (SD 8.3), with 2477 (49.0%) males. Of the 1410 high-risk patients who underwent high-resolution plethysmography (HRPO), 1092 were sleep-disordered breathing positive (oxygen desaturation index [ODI] ≥5) and 680 high-risk patients underwent polysomnography. In this latter group, 585 (87%) were found to have sleep-disordered breathing (apnea-hypopnea index [AHI] >5). A receiver operating characteristic curve for ODI derived from HRPO plotted against AHI from polysomnography showed an area under the curve of 0.83 for an ODI of >5. Patients who were adherent to positive airway pressure therapy in the first 3 months had improved survival over a mean follow-up of 609 days compared with those who were nonadherent (P = .01). CONCLUSION: This large database of hospitalized patients confirms a high prevalence of undetected sleep-disordered breathing. Long-term follow-up of those compliant with treatment reveals a survival benefit.
PURPOSE:Sleep-disordered breathing is a common sleep disorder. Recent studies have shown that hospitalized obesepatients have a high likelihood of unrecognized sleep-disordered breathing. However, no systematic large study has so far evaluated the outcomes of a screening program. This study provides demographic, clinical, and outcome data from a screening program at a tertiary care academic center. METHODS: Subjects were 5062 patients screened from March 2013 to July 2016. Of these, 1410 underwent in-hospital overnight high-resolution pulse oximetry and 680 underwent polysomnography post discharge. Patients placed on positive airway therapy were followed in an ambulatory setting. RESULTS: The mean age was 60.7 years (SD 15.2), and mean body mass index was 34.8 kg/m2 (SD 8.3), with 2477 (49.0%) males. Of the 1410 high-risk patients who underwent high-resolution plethysmography (HRPO), 1092 were sleep-disordered breathing positive (oxygen desaturation index [ODI] ≥5) and 680 high-risk patients underwent polysomnography. In this latter group, 585 (87%) were found to have sleep-disordered breathing (apnea-hypopnea index [AHI] >5). A receiver operating characteristic curve for ODI derived from HRPO plotted against AHI from polysomnography showed an area under the curve of 0.83 for an ODI of >5. Patients who were adherent to positive airway pressure therapy in the first 3 months had improved survival over a mean follow-up of 609 days compared with those who were nonadherent (P = .01). CONCLUSION: This large database of hospitalized patients confirms a high prevalence of undetected sleep-disordered breathing. Long-term follow-up of those compliant with treatment reveals a survival benefit.
Authors: Robert Stansbury; Patrick Strollo; Nathan Pauly; Ira Sharma; Marco Schaaf; Anina Aaron; Judith Feinberg Journal: J Clin Sleep Med Date: 2022-03-01 Impact factor: 4.062
Authors: Daniel Álvarez; Gonzalo C Gutiérrez-Tobal; Fernando Vaquerizo-Villar; Fernando Moreno; Félix Del Campo; Roberto Hornero Journal: Adv Exp Med Biol Date: 2022 Impact factor: 3.650