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Rizzo D, Baltzan M, Sirpal S, Dosman J, Kaminska M, Chung F. Prevalence and regional distribution of obstructive sleep apnea in Canada: Analysis from the Canadian Longitudinal Study on Aging. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024:10.17269/s41997-024-00911-8. [PMID: 39037568 DOI: 10.17269/s41997-024-00911-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 06/03/2024] [Indexed: 07/23/2024]
Abstract
OBJECTIVES Obstructive sleep apnea (OSA) is a common chronic condition that is often undiagnosed or diagnosed after many years of symptoms and has an impact on quality of life and several health factors. We estimated the Canadian national prevalence of OSA using a validated questionnaire and physical measurements in participants in the Canadian Longitudinal Study on Aging (CLSA). METHODS The method used individual risk estimation based upon the validated STOP-BANG scale developed for OSA. This stratified population sample spans Canada to provide regional estimates. RESULTS In this sample of adults aged 45 to 85 years old, the overall prevalence in 2015 of combined moderate and severe OSA in the 51,337 participants was 28.1% (95% confidence intervals, 27.8‒28.4). The regional prevalence varied statistically between Atlantic Canada and Western Canada (p < 0.001), although clinically the variations were limited. The provincial prevalence for moderate and severe OSA ranged from 27.5% (New Brunswick and British Columbia) to 29.1% (Manitoba). Body mass index (BMI) was the dominant determinant of the variance between provinces (β = 0.33, p < 0.001). Only 1.2% of participants had a clinical diagnosis of OSA. CONCLUSION The great majority (92.9%) of the participants at high risk of OSA were unrecognized and had no clinical diagnosis of OSA.
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Affiliation(s)
| | - Marc Baltzan
- Hôpital Mont-Sinaï, Montréal, QC, Canada
- Faculty of Medicine, McGill University; St. Mary's Hospital, Montréal, QC, Canada
| | - Sanjeev Sirpal
- Department of Emergency Medicine, CIUSSS Nord-de-L'Ile-de-Montréal, Montréal, QC, Canada
| | - James Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Marta Kaminska
- Respiratory Epidemiology and Clinical Research Unit, Respiratory Division and Sleep Laboratory, Department of Medicine, McGill University Health Centre, Montréal, QC, Canada
| | - Frances Chung
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
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Taimah M, Ahmad A, Al-Houqani M, Al Junaibi A, Idaghdour Y, Abdulle A, Ali R. Association between obstructive sleep apnea risk and type 2 diabetes among Emirati adults: results from the UAE healthy future study. Front Endocrinol (Lausanne) 2024; 15:1395886. [PMID: 39081790 PMCID: PMC11286458 DOI: 10.3389/fendo.2024.1395886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Obstructive sleep apnea (OSA) can have negative impacts on the health outcomes of individuals with type 2 diabetes. However, in the United Arab Emirates (UAE), there is a lack of understanding regarding the relationship between OSA and type 2 diabetes despite the significant implications it has on health. The primary objective of this study is to investigate the association between OSA risk and type 2 diabetes, associated risk factors, and gender differences in OSA symptoms among Emirati adults. Methods We conducted a cross-sectional analysis of the baseline data from the UAE Healthy Future Study (UAEHFS) collected between February 2016 and March 2023. Our sample consisted of 4578 participants aged 18-71 who completed the STOP-BANG survey, provided body measurements and blood samples. We stratified the patients according to their OSA risk and diabetes. We used univariate and multivariate logistic regression models to analyze the relationship between OSA risk and type 2 diabetes and to identify factors associated with risk for OSA and type 2 diabetes. We estimated odds ratios (ORs) with corresponding 95% confidence intervals (95% CI). Results The mean age was 27.5 years (± 8.35), and 55.81% (n=2555) were men. The overall prevalence of high risk for OSA was 16.58% and was higher in men compared to women (26.46% vs 4.10%). Women reported feeling tired more often than men (68.02% vs 48.96%). Both genders have similar rates of stop breathing and BMI ≥ 35. There was a significant association between the OSA risk and type 2 diabetes in the unadjusted model (OR=2.44; 95% CI: 1.78-3.35; p-value <0.0001) and (OR=6.44; 95% CI: 4.32-9.59; p-value < 0.0001) among those who reported intermediate and high OSA risk, respectively. After adjusting the model for education attainment, marital status, waist circumference, and smoking, the association remained significant between diabetes and OSA risk, with an OR of 1.65 (95%CI: 1.18-2.32; p-value =0.004) for intermediate OSA risk and 3.44 (95%CI: 2.23-5.33; p-value <0.0001) for high OSA risk. Conclusions This study conducted in the UAE found a significant correlation between OSA risk and type 2 diabetes. We suggest introducing routine screening of OSA for individuals with diabetes.
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Affiliation(s)
- Manal Taimah
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Amar Ahmad
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Mohammad Al-Houqani
- Department of Medicine, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Abdulla Al Junaibi
- Department of Pediatrics, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Youssef Idaghdour
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - AbdiShakur Abdulle
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Raghib Ali
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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Duarte RLM, Magalhães-da-Silveira FJ, Gozal D. Sex-dependent GOAL screening performance in adults at risk for obstructive sleep apnea. Pulmonology 2024; 30:265-271. [PMID: 35151621 DOI: 10.1016/j.pulmoe.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/19/2021] [Accepted: 01/08/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To evaluate possible sex-related differences in the performance of the GOAL, a 4-item obstructive sleep apnea (OSA) screening instrument in adults. METHODS Between July 2019 and June 2021, this cross-sectional study included consecutively recruited patients from one Brazilian sleep laboratory undergoing overnight polysomnography. Individuals with GOAL scores ≥ 2 of a maximum of 4 points are classified at high risk for OSA diagnosis. Actual OSA severity was based on the apnea-hypopnea index: ≥ 5.0/h as any OSA, ≥ 15.0/h as moderate-to-severe OSA, and ≥ 30.0/h as severe OSA. Performance of the GOAL instrument in women and men was assessed by the discriminatory ability (obtained from area under the curve [AUC]-Receiver Operating Characteristic curves) and 2×2 contingency tables. RESULTS A total of 2,978 subjects (55.3% males) were evaluated. The frequency of GOAL-defined OSA high-risk was statistically higher in men when compared to women (p < 0.001). The GOAL predictive parameters for screening all severity OSA levels were as follows: in females, sensitivity ranging from 58.2% to 78.3% and specificity ranging from 60.0% to 77.6%, while in males, sensitivity ranging from 90.5% to 96.9% and specificity from 20.7% to 46.8%. The GOAL questionnaire had similar discriminatory properties, assessed by AUC, in women and in men: i) any OSA: 0.741 vs. 0.771 (p = 0.204), ii) moderate-to-severe OSA: 0.727 vs. 0.737 (p = 0.595), and iii) severe OSA: 0.728 vs. 0.703 (p = 0.240); respectively. CONCLUSIONS The GOAL instrument emerges as a useful tool for screening adult individuals and displays similar performance in both women and men.
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Affiliation(s)
- R L M Duarte
- SleepLab - Laboratório de Estudo dos Distúrbios do Sono, Rio de Janeiro, Brazil; Instituto de Doenças do Tórax - Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
| | | | - D Gozal
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
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Jung SM, Lee MR. Association between Obstructive Sleep Apnea and Chronic Kidney Disease According to Sex, Long Working Hours: The Korean National Health and Nutrition Examination Survey (2019-2020). Life (Basel) 2023; 13:1625. [PMID: 37629482 PMCID: PMC10455091 DOI: 10.3390/life13081625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/06/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
This study aimed to investigate whether obstructive sleep apnea (OSA) is associated with an increased risk of chronic kidney disease (CKD) and to perform subgroup analysis by sex and working hours. This cross-sectional study was conducted on 8157 subjects who participated in the Korea National Health and Nutrition Examination Survey (KNHANES). The adults completed the STOP-BANG score to measure their risk of OSA, and blood and urine samples were collected to ascertain the severity of CKD based on the estimated glomerular filtration rate and urine albumin-to-creatinine ratio. Multivariate logistic regression was used for complex sample analysis. After fully adjusting for the confounding variables, the high-risk OSA group showed a significantly higher risk of developing albuminuria and CKD than the low-risk group, particularly among men. Odds ratio (OR) 1.72, 95% confidence interval (CI) 1.13-2.6 and (OR 1.67, 95% CI 1.14-2.45), respectively. Additionally, men who worked for 40 h/week showed a significant association between OSA, CKD, and albuminuria. This study supports the link between OSA and the risk of kidney disease, especially among men and those who work long hours. Screening and treating OSA may be a crucial strategy for preventing kidney disease, particularly in high-risk populations.
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Affiliation(s)
- Sung-Min Jung
- Department of Surgery, Inje University, Ilsan Paik Hospital, Goyang-si 10380, Republic of Korea;
| | - Mee-Ri Lee
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan-si 31151, Republic of Korea
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Kalkanis A, Testelmans D, Papadopoulos D, Van den Driessche A, Buyse B. Insights into the Use of Point-of-Care Ultrasound for Diagnosing Obstructive Sleep Apnea. Diagnostics (Basel) 2023; 13:2262. [PMID: 37443656 DOI: 10.3390/diagnostics13132262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/06/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
Obstructive sleep apnea (OSA) is a sleeping disorder caused by complete or partial disturbance of breathing during the night. Existing screening methods include questionnaire-based evaluations which are time-consuming, vary in specificity, and are not globally adopted. Point-of-care ultrasound (PoCUS), on the other hand, is a painless, inexpensive, portable, and useful tool that has already been introduced for the evaluation of upper airways by anesthetists. PoCUS could also serve as a potential screening tool for the diagnosis of OSA by measuring different airway parameters, including retropalatal pharynx transverse diameter, tongue base thickness, distance between lingual arteries, lateral parapharyngeal wall thickness, palatine tonsil volume, and some non-airway parameters like carotid intima-media thickness, mesenteric fat thickness, and diaphragm characteristics. This study reviewed previously reported studies to highlight the importance of PoCUS as a potential screening tool for OSA.
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Affiliation(s)
- Alexandros Kalkanis
- Department of Respiratory Diseases, University Hospitals Leuven, KU Leuven, Campus Gasthuisberg, 3000 Leuven, Belgium
| | - Dries Testelmans
- Department of Respiratory Diseases, University Hospitals Leuven, KU Leuven, Campus Gasthuisberg, 3000 Leuven, Belgium
| | - Dimitrios Papadopoulos
- Department of Respiratory Diseases, University Hospitals Leuven, KU Leuven, Campus Gasthuisberg, 3000 Leuven, Belgium
| | | | - Bertien Buyse
- Department of Respiratory Diseases, University Hospitals Leuven, KU Leuven, Campus Gasthuisberg, 3000 Leuven, Belgium
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Duarte RLM, Magalhães-da-Silveira FJ, Gozal D. Screening for obstructive sleep apnea: comparing the American Academy of Sleep Medicine proposed criteria with the STOP-Bang, NoSAS, and GOAL instruments. J Clin Sleep Med 2023; 19:1239-1246. [PMID: 36872648 PMCID: PMC10315593 DOI: 10.5664/jcsm.10546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 03/07/2023]
Abstract
STUDY OBJECTIVES We evaluated the performance of the 2017 American Academy of Sleep Medicine criteria (AASM2017) in screening obstructive sleep apnea (OSA) and compared them with 3 other validated instruments: NoSAS score, STOP-Bang, and GOAL questionnaires. METHODS From July 2019 to December 2021, 4,499 adults undergoing overnight polysomnography were included. The AASM2017 instrument considers an increased high risk for moderate-to-severe OSA in the presence of excessive daytime sleepiness and at least 2 of the following 3 criteria: loud snoring; observed apnea, gasping, or choking; and hypertension. OSA severity was based on polysomnography-derived apnea-hypopnea index cutoffs: 5.0 events/h, 15.0 events/h, and 30.0 events/h. Predictive performance was evaluated by the area under the curve and contingency tables. RESULTS When screening for any OSA severity, AASM2017 displayed a sensitivity of 31.0-40.6% and a specificity of 80.8-89.6%. For all apnea-hypopnea index thresholds, AASM2017, unlike the GOAL, STOP-Bang, and NoSAS, exhibited superior specificity but markedly lower sensitivity. GOAL, STOP-Bang, and NoSAS, but not AASM2017 criteria, emerged as an adequate screening tool for any OSA severity (all areas under the curve > 0.7) and performed significantly better than AASM2017 in predicting any OSA severity (all P < .001). For all severity OSA levels, GOAL, STOP-Bang, and NoSAS displayed similar performance when compared to each other (all P > .05). CONCLUSIONS GOAL, STOP-Bang, and NoSAS instruments, but not AASM2017 criteria, emerge as useful OSA screening tools in a large referral single-center clinical cohort. CITATION Duarte RLM, Magalhães-da-Silveira FJ, Gozal D. Screening for obstructive sleep apnea: comparing the American Academy of Sleep Medicine proposed criteria with the STOP-Bang, NoSAS, and GOAL instruments. J Clin Sleep Med. 2023;19(7):1239-1246.
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Affiliation(s)
- Ricardo L. M. Duarte
- SleepLab, Laboratório de Estudo dos Distúrbios do Sono, Centro Médico BarraShopping, Rio de Janeiro, Brazil
- Instituto de Doenças do Tórax, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - David Gozal
- Department of Child Health, University of Missouri School of Medicine, Columbia, Missouri
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Argel M, Cunha Â, Conceição M, Abrantes T, Torres AS. Screening for Obstructive Sleep Apnea in truck drivers. CIENCIA & SAUDE COLETIVA 2023; 28:1863-1872. [PMID: 37255162 DOI: 10.1590/1413-81232023286.16022022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 11/15/2022] [Indexed: 06/01/2023] Open
Abstract
Professional drivers show a higher prevalence of obstructive sleep apnea (OSA) compared with the general population. OSA has been widely associated with an increased risk of traffic accidents. This article aims to investigate the presence of risk factors for OSA, its prevalence and the value of screening tools in a truck drivers' cohort. Descriptive and analytical prospective study. Demographic, anthropometric, Epworth Sleepiness Scale, STOP-Bang and Berlin Questionnaire were used to select subjects with suspicion of OSA. Polysomnography (PSG) was performed in individuals with positive screening. Mean age was 44.6±7 years, mean body mass index was 28.7±4 kg/m². Of the 281 truck drivers screened, 88 were positive for potential OSA. Of these, 63 completed PSG study and the diagnosis was confirmed in 85.7% (prevalence of 19.2%). The following variables showed a positive correlation with the apnea-hypopnea index: neck circumference and STOP-Bang. The combination of a predominantly male population, obesity, age distribution and lifestyle could account for the high prevalence of OSA in this specific population. Questionnaires proved to be a valuable screening tool. Screening, treatment, and management of OSA should be a priority as a public safety policy.
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Affiliation(s)
- Mariana Argel
- Departamento de Pneumologia, Centro Hospitalar Tondela-Viseu, E.P.E. Avenida Rei D. Duarte, 3504-509. Viseu Portugal.
| | - Ângela Cunha
- Departamento de Pneumologia, Centro Hospitalar Tondela-Viseu, E.P.E. Avenida Rei D. Duarte, 3504-509. Viseu Portugal.
| | - Mariana Conceição
- Departamento de Pneumologia, Centro Hospitalar Tondela-Viseu, E.P.E. Avenida Rei D. Duarte, 3504-509. Viseu Portugal.
| | - Tito Abrantes
- Departamento de Pneumologia, Centro Hospitalar Tondela-Viseu, E.P.E. Avenida Rei D. Duarte, 3504-509. Viseu Portugal.
| | - António Simões Torres
- Departamento de Pneumologia, Centro Hospitalar Tondela-Viseu, E.P.E. Avenida Rei D. Duarte, 3504-509. Viseu Portugal.
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Betz K, Verhaert DVM, Gawalko M, Hermans ANL, Habibi Z, Pluymaekers NAHA, van der Velden RMJ, Homberg M, Philippens S, Hereijgers MJM, Vorstermans B, Simons SO, den Uijl DW, Chaldoupi SM, Luermans JGLM, Westra SW, Lankveld T, van Steenwijk RP, Hol B, Schotten U, Vernooy K, Hendriks JM, Linz D. Atrial fibrillation-specific refinement of the STOP-Bang sleep apnoea screening questionnaire: insights from the Virtual-SAFARI study. Clin Res Cardiol 2023; 112:834-845. [PMID: 36773038 PMCID: PMC10241725 DOI: 10.1007/s00392-023-02157-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/10/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Sleep-disordered breathing (SDB) is prevalent in up to 50% of patients referred for atrial fibrillation (AF) catheter ablation (CA). Currently, it remains unclear how to improve pre-selection for SDB screening in patients with AF. AIM We aimed to (1) assess the accuracy of the STOP-Bang screening questionnaire for detection of SDB within an AF population referred for CA; (2) derive a refined, AF-specific SDB score to improve pre-selection. METHODS Consecutive AF patients referred for CA without a history of SDB and/or SDB screening were included. Patients were digitally referred to the previously implemented Virtual-SAFARI SDB screening and management pathway including a home sleep test. An apnoea-hypopnoea index (AHI) of ≥ 15 was interpreted as moderate-to-severe SDB. Logistic regression analysis was used to assess characteristics associated with moderate-to-severe SDB to refine pre-selection for SDB screening. RESULTS Of 206 included patients, 51% were diagnosed with moderate-to-severe SDB. The STOP-Bang questionnaire performed poorly in detecting SDB, with an area under the receiver operating characteristic curve (AUROC) of 0.647 (95% Confidence-Interval (CI) 0.573-0.721). AF-specific refinement resulted in the BOSS-GAP score. Therein, BMI with cut-off point ≥ 27 kg/m2 and previous stroke or transient ischaemic attack (TIA) were added, while tiredness and neck circumference were removed. The BOSS-GAP score performed better with an AUROC of 0.738 (95% CI 0.672-0.805) in the overall population. CONCLUSION AF-specific refinement of the STOP-Bang questionnaire moderately improved detection of SDB in AF patients referred for CA. Whether questionnaires bring benefits for pre-selection of SDB compared to structural screening in patients with AF requires further studies. TRIAL REGISTRATION NUMBER ISOLATION was registered NCT04342312, 13-04-2020.
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Affiliation(s)
- Konstanze Betz
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- Department of Internal Medicine, Eifelklinik St. Brigida GmbH & Co. KG, Kammerbruchstraße 8, 52152, Simmerath, Germany
| | - Dominique V M Verhaert
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- Department of Cardiology, Radboud University Medical Center and Radboud Institute for Health Sciences, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Monika Gawalko
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- 1St Department of Cardiology, Doctoral School, Medical University of Warsaw, Żwirki i Wigury 61, 02-091, Warsaw, Poland
- Institute of Pharmacology, West German Heart and Vascular Centre, University Duisburg-Essen, Forsthausweg 2, 47057, Duisburg, Germany
| | - Astrid N L Hermans
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Zarina Habibi
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- Department of Cardiology, Radboud University Medical Center and Radboud Institute for Health Sciences, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Nikki A H A Pluymaekers
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Rachel M J van der Velden
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Marloes Homberg
- Department of Anesthesiology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Suzanne Philippens
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Maartje J M Hereijgers
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Bianca Vorstermans
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Sami O Simons
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Dennis W den Uijl
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Sevasti-Maria Chaldoupi
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Justin G L M Luermans
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Sjoerd W Westra
- Department of Cardiology, Radboud University Medical Center and Radboud Institute for Health Sciences, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Theo Lankveld
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | | | - Bernard Hol
- Netherland Sleep Institute, Computerweg 4, 3821 AB, Amersfoort, The Netherlands
| | - Ulrich Schotten
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Kevin Vernooy
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
- Department of Cardiology, Radboud University Medical Center and Radboud Institute for Health Sciences, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Jeroen M Hendriks
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Port Rd, Adelaide, SA, 5000, Australia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, Adelaide, SA, 5042, Australia
| | - Dominik Linz
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
- Department of Cardiology, Radboud University Medical Center and Radboud Institute for Health Sciences, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Port Rd, Adelaide, SA, 5000, Australia.
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, Adelaide, SA, 5042, Australia.
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Nørregade 10, 1165, Copenhagen, Denmark.
- Maastricht UMC+, Maastricht Heart+Vascular Center, 6202 AZ, Maastricht, The Netherlands.
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Łoboda D, Stepanik M, Szajerska-Kurasiewicz A, Turski M, Urbanczyk-Świć D, Durmała J, Gołba KS. The Usefulness of Questionnaires in Assessing the Risk of Obstructive Sleep Apnea in Patients in the Managed Care after Acute Myocardial Infarction Program-The Results of a Cross-Sectional Study. J Pers Med 2023; 13:jpm13040642. [PMID: 37109027 PMCID: PMC10142237 DOI: 10.3390/jpm13040642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
Obstructive sleep apnea (OSA) worsens prognosis after myocardial infarction (MI) but often remains undiagnosed. The study aimed to evaluate the usefulness of questionnaires in assessing the risk of OSA in patients participating in managed care after an acute myocardial infarction program. Study group: 438 patients (349 (79.7%) men) aged 59.92 ± 10.92, hospitalized in the day treatment cardiac rehabilitation department 7-28 days after MI. OSA risk assessment: A 4-variable screening tool (4-V), STOP-BANG questionnaire, Epworth sleepiness scale (ESS), and adjusted neck circumference (ANC). The home sleep apnea testing (HSAT) was performed on 275 participants. Based on four scales, a high risk of OSA was found in 283 (64.6%) responders, including 248 (56.6%) based on STOP-BANG, 163 (37.5%) based on ANC, 115 (26.3%) based on 4-V, and 45 (10.3%) based on ESS. OSA was confirmed in 186 (68.0%) participants: mild in 85 (30.9%), moderate in 53 (19.3%), and severe in 48 (17.5%). The questionnaires' sensitivity and specificity in predicting moderate-to-severe OSA were: for STOP-BANG-79.21% (95% confidence interval; CI 70.0-86.6) and 35.67% (95% CI 28.2-43.7); ANC-61.39% (95% CI 51.2-70.9) and 61.15% (95% CI 53.1-68.8); 4-V-45.54% (95% CI 35.6-55.8) and 68.79% (95% CI 60.9-75.9); ESS-16.83% (95% CI 10.1-25.6) and 87.90% (95% CI 81.7-92.6). OSA is common in post-MI patients. The ANC most accurately estimates the risk of OSA eligible for positive airway pressure therapy. The sensitivity of the ESS in the post-MI population is insufficient and limits this scale's usefulness in risk assessment and qualification for treatment.
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Affiliation(s)
- Danuta Łoboda
- Department of Electrocardiology and Heart Failure, Medical University of Silesia in Katowice, 40-635 Katowice, Poland
- Department of Electrocardiology, Upper-Silesian Medical Centre, 40-635 Katowice, Poland
| | - Michalina Stepanik
- Department of Rehabilitation, Medical University of Silesia in Katowice, 40-635 Katowice, Poland
| | | | - Maciej Turski
- Day Treatment Cardiac Rehabilitation Ward, Upper-Silesian Medical Centre, 40-635 Katowice, Poland
| | - Dagmara Urbanczyk-Świć
- Day Treatment Cardiac Rehabilitation Ward, Upper-Silesian Medical Centre, 40-635 Katowice, Poland
| | - Jacek Durmała
- Department of Rehabilitation, Medical University of Silesia in Katowice, 40-635 Katowice, Poland
| | - Krzysztof S Gołba
- Department of Electrocardiology and Heart Failure, Medical University of Silesia in Katowice, 40-635 Katowice, Poland
- Department of Electrocardiology, Upper-Silesian Medical Centre, 40-635 Katowice, Poland
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10
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Samaha H, El-Hadidy A, Younis A, El-Shafe M, Saker S, Elsaid A. Sleep-disordered breathing in chronic compensated heart failure. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2023. [DOI: 10.4103/ecdt.ecdt_111_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
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11
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Hong Y, Mo H, Cho SJ, Im HJ. Wake-up ischemic stroke associated with short sleep duration and sleep behavior: A stratified analysis according to risk of obstructive sleep apnea. Sleep Med 2023; 101:497-504. [PMID: 36527941 DOI: 10.1016/j.sleep.2022.11.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/30/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Wake-up stroke (WUS) is an ischemic stroke occurring during nocturnal sleep with neurological deficits observed upon awakening. Our study aimed to investigate the association between WUS, sleep curtailment, and sleep behavior according to the obstructive sleep apnea (OSA) risk in patients with acute ischemic stroke. METHODS This single-centered, retrospective study included hospitalized subjects with acute ischemic stroke occurring within 30 days. A total of 250 participants were classified as WUS or not and enquired about their sleep habits concerning sleep time on weekdays and weekends, demographic factors, and assessed comorbid medical conditions. Weekend catch-up sleep (CUS) was defined as the extension of sleep duration during weekends. The average weekly sleep duration and chronotype were assessed. The association between WUS and sleep factors was analyzed. RESULTS WUS was observed in 70 patients (28.0%) with acute ischemic stroke. There were no significant differences in the demographic and stroke-related variables between the WUS and non-WUS (NWUS) groups. Upon stratified analysis based on risk of OSA, average weekly sleep duration (odds ratio, [OR] = 0.60, 95% confidence interval, [CI] = 0.41-0.89; p = 0.011), the presence of weekend CUS (OR = 0.07, 95% CI = 0.01-0.97; p = 0.047), and chronotype (OR = 0.62, 95% CI = 0.39-0.98; p = 0.041) were independently associated with WUS in low-risk group with OSA, but not in the high-risk group. CONCLUSIONS Short sleep duration and lack of compensation are significantly associated with WUS in low-risk OSA group. Insufficient sleep and sleep behaviors could play a different role in causing ischemic stroke during sleep when patients are stratified by their risk of sleep apnea.
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Affiliation(s)
- Yooha Hong
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Heejung Mo
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Hee-Jin Im
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea.
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12
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Hwang M, Nagappa M, Guluzade N, Saripella A, Englesakis M, Chung F. Validation of the STOP-Bang questionnaire as a preoperative screening tool for obstructive sleep apnea: a systematic review and meta-analysis. BMC Anesthesiol 2022; 22:366. [PMID: 36451106 PMCID: PMC9710034 DOI: 10.1186/s12871-022-01912-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a common disorder that is highly associated with postoperative complications. The STOP-Bang questionnaire is a simple screening tool for OSA. The objective of this systematic review and meta-analysis is to evaluate the validity of the STOP-Bang questionnaire for screening OSA in the surgical population cohort. METHODS A systematic search of the following databases was performed from 2008 to May 2021: MEDLINE, Medline-in-process, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PsycINFO, Journals @ Ovid, Web of Science, Scopus, and CINAHL. Continued literature surveillance was performed through October 2021. RESULTS The systematic search identified 4641 articles, from which 10 studies with 3247 surgical participants were included in the final analysis. The mean age was 57.3 ± 15.2 years, and the mean BMI was 32.5 ± 10.1 kg/m2 with 47.4% male. The prevalence of all, moderate-to-severe, and severe OSA were 65.2, 37.7, and 17.0%, respectively. The pooled sensitivity of the STOP-Bang questionnaire for all, moderate-to-severe, and severe OSA was 85, 88, and 90%, and the pooled specificities were 47, 29, and 27%, respectively. The area under the curve for all, moderate-to-severe, and severe OSA was 0.84, 0.67, and 0.63. CONCLUSIONS In the preoperative setting, the STOP-Bang questionnaire is a valid screening tool to detect OSA in patients undergoing surgery, with a high sensitivity and a high discriminative power to reasonably exclude severe OSA with a negative predictive value of 93.2%. TRIAL REGISTRATION PROSPERO registration CRD42021260451 .
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Affiliation(s)
- Mark Hwang
- grid.17091.3e0000 0001 2288 9830Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada ,grid.231844.80000 0004 0474 0428Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON M5T 2S8 Canada
| | - Mahesh Nagappa
- grid.39381.300000 0004 1936 8884Department of Anesthesia & Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, ON Canada
| | - Nasimi Guluzade
- grid.231844.80000 0004 0474 0428Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON M5T 2S8 Canada
| | - Aparna Saripella
- grid.231844.80000 0004 0474 0428Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON M5T 2S8 Canada
| | - Marina Englesakis
- grid.231844.80000 0004 0474 0428Library and Information Services, University Health Network, Toronto, ON Canada
| | - Frances Chung
- grid.231844.80000 0004 0474 0428Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON M5T 2S8 Canada ,grid.231844.80000 0004 0474 0428Department of Anesthesiology and Pain Management, University Health Network, University of Toronto, MCL 2-405, 399 Bathurst Street, Toronto, ON M5T 2S8 Canada
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13
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The value of nurse-led anthropometric and oropharyngeal measurements combined with STOP-Bang questionnaire in screening for obstructive sleep apnea in patients with acute coronary syndrome: a prospective cohort study. BMC Pulm Med 2022; 22:396. [PMCID: PMC9632106 DOI: 10.1186/s12890-022-02200-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
Obstructive sleep apnea (OSA) is a modifiable risk factor for acute coronary syndrome (ACS), with high prevalence but low diagnostic rates. Therefore, it is particularly important to develop strategies for better screening for OSA in newly admitted ACS patients.
Methods
From March 2017 to October 2019, consecutive eligible patients with ACS underwent cardiorespiratory polygraphy during hospitalization. OSA was defined as an apnea–hypopnea index (AHI) ≥ 15 events/h. All anthropometric and oropharyngeal parameters are measured by specialist nurses.
Results
Finally, 761 ACS patients were recruited in the present study. Prevalence of moderate/severe OSA was 53.2% based on diagnostic criteria of AHI ≥ 15. Correlation analysis illustrated that AHI was positively correlated with anthropometric characteristics. In the multivariate model, only micrognathia (OR 2.02, 95% CI 1.02–4.00, P = 0.044), waist circumference (OR 1.08, 95% CI 1.04–1.11, P < 0.001), and STOP-BANG Questionnaire (SBQ) score (OR 1.45, 95% CI 1.27–1.66, P < 0.001) were independently associated with the prevalence of OSA. Receiver operating characteristic curve (ROC) analysis showed that the area under curve (AUC) of multivariable joint diagnosis (waist circumference, micrognathia combined with SBQ) was significantly better than the AUC of Epworth Sleepiness Scale (ESS) and SBQ (p < 0.0001 and p = 0.0002, respectively), and the results showed that AUC was 0.728. Under the optimal truncation value, the sensitivity was 73%, and the specificity was 61%, which was higher than the single index. Finally, we also constructed a nomogram model based on multiple logistic regression, to easily determine the probability of OSA in ACS patients.
Conclusions
The new screening tool has greater power than single questionnaire or measurements in screening of OSA among ACS patients.
Trial registration
Clinicaltrials.gov identifier NCT03362385, registered December 5, 2017.
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14
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Romano S, Lo Bue A, Salvaggio A, Oliveira LVF, Ferini-Strambi L, Insalaco G. SANReSP: A new Italian questionnaire to screen patients for obstructive sleep apnea. PLoS One 2022; 17:e0276217. [PMID: 36240186 PMCID: PMC9565397 DOI: 10.1371/journal.pone.0276217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/02/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose Obstructive sleep apnea (OSA) is a common, prevalent, and underdiagnosed disorder. Its lack of diagnosis and treatment is associated with increased morbidity and mortality. Previous screening questionnaires investigated parameters including body mass index, age, neck circumference, and sex, in addition to symptoms. This study aimed to validate a new Italian, self-administered, and easy-to-use six-item questionnaire that evaluates only subjective symptoms. Patients and methods The present study included 2622 patients (male, 2011; female, 611). Patients who were at least 18 years old, spoke Italian, referred to our sleep clinic for possible OSA, and completed the self-administered SANReSP questionnaire were recruited for the study. The predictive performance of the questionnaire was also evaluated. Results Nocturnal study showed 89.9% of OSA patients had apnea-hypopnea index (AHI) ≥ 5/h; 68.7%, AHI ≥ 15/h; and 48.2%, AHI ≥ 30/h. The optimal SANReSP score for AHI ≥ 5/h was >3 with a sensitivity and specificity of 74.76% and 67.92%, respectively, and an area under receiver operating characteristic curve (ROC) of 0.76. For moderate–severe OSA, the optimal SANReSP score was >3 (sensitivity, 78.18%; specificity, 46.53%; ROC, 0.66). For severe OSA, the optimal SANReSP score was >4 (sensitivity, 59.10%; specificity, 64.73%; ROC, 0.65). The probability of OSA increased with higher SANReSP scores (98.7% and 97.9% in men and women, respectively). Conclusion The SANReSP questionnaire is a short, easy-to-use, and self-administered screening tool for OSA. Its performance is similar to that of other widely used questionnaires; furthermore, it is advantageous in that it does not require anthropometric measurements.
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Affiliation(s)
- Salvatore Romano
- National Research Council of Italy, Institute for Biomedical Research and Innovation (IRIB), Palermo, Italy
| | - Anna Lo Bue
- National Research Council of Italy, Institute for Biomedical Research and Innovation (IRIB), Palermo, Italy
- National Research Council of Italy, Institute of Translational Pharmacology (IFT), Palermo, Italy
| | - Adriana Salvaggio
- National Research Council of Italy, Institute for Biomedical Research and Innovation (IRIB), Palermo, Italy
- National Research Council of Italy, Institute of Translational Pharmacology (IFT), Palermo, Italy
| | - Luis V. F. Oliveira
- Evangelical University of Goiás (UniEVANGÉLICA), Postgraduate Program in Human Movement and Rehabilitation–PPGMHR, Anapolis, Brazil
| | - Luigi Ferini-Strambi
- Università Vita-Salute San Raffaele, and Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giuseppe Insalaco
- National Research Council of Italy, Institute for Biomedical Research and Innovation (IRIB), Palermo, Italy
- National Research Council of Italy, Institute of Translational Pharmacology (IFT), Palermo, Italy
- * E-mail:
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15
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Dosman JA, Karunanayake CP, Fenton M, Ramsden VR, Seeseequasis J, Mike D, Seesequasis W, Neubuhr M, Skomro R, Kirychuk S, Rennie DC, McMullin K, Russell BP, Koehncke N, Abonyi S, King M, Pahwa P. STOP-Bang Score and Prediction of Severity of Obstructive Sleep Apnea in a First Nation Community in Saskatchewan, Canada. Clocks Sleep 2022; 4:535-548. [PMID: 36278535 PMCID: PMC9624327 DOI: 10.3390/clockssleep4040042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/18/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
Abstract
The STOP-Bang questionnaire is an easy-to-administer scoring model to screen and identify patients at high risk of obstructive sleep apnea (OSA). However, its diagnostic utility has never been tested with First Nation peoples. The objective was to determine the predictive parameters and the utility of the STOP-Bang questionnaire as an OSA screening tool in a First Nation community in Saskatchewan. The baseline survey of the First Nations Sleep Health Project (FNSHP) was completed between 2018 and 2019. Of the available 233 sleep apnea tests, 215 participants completed the STOP-Bang score questionnaire. A proportional odds ordinal logistic regression analysis was conducted using the total score of the STOP-Bang as the independent variable with equal weight given to each response. Predicted probabilities for each score at cut-off points of the Apnea Hypopnea Index (AHI) were calculated and plotted. To assess the performance of the STOP-Bang questionnaire, sensitivity, specificity, positive predictive values (PPVs), negative predictive values (NPVs), and area under the curve (AUC) were calculated. These data suggest that a STOP-Bang score ≥ 5 will allow healthcare professionals to identify individuals with an increased probability of moderate-to-severe OSA, with high specificity (93.7%) and NPV (91.8%). For the STOP-Bang score cut-off ≥ 3, the sensitivity was 53.1% for all OSA and 72.0% for moderate-to-severe OSA. For the STOP-Bang score cut-off ≥ 3, the specificity was 68.4% for all OSA and 62.6% for moderate-to-severe OSA. The STOP-Bang score was modestly superior to the symptom of loud snoring, or loud snoring plus obesity in this population. Analysis by sex suggested that a STOP-Bang score ≥ 5 was able to identify individuals with increased probability of moderate-to-severe OSA, for males with acceptable diagnostic test accuracy for detecting participants with OSA, but there was no diagnostic test accuracy for females.
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Affiliation(s)
- James A. Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
- Correspondence: (J.A.D.); (C.P.K.); Tel.: +1-306-966-1475 (J.A.D.); +1-306-966-1647 (C.P.K.)
| | - Chandima P. Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Correspondence: (J.A.D.); (C.P.K.); Tel.: +1-306-966-1475 (J.A.D.); +1-306-966-1647 (C.P.K.)
| | - Mark Fenton
- Department of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
- Division of Respirology, Critical Care, and Sleep Medicine, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Vivian R. Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, West Winds Primary Health Centre, 3311 Fairlight Drive, Saskatoon, SK S7M 3Y5, Canada
| | - Jeremy Seeseequasis
- Willow Cree Health Services, Beardy’s & Okemasis Cree Nation, P.O. Box 96, Duck Lake, SK S0K 1J0, Canada
- Beardy’s & Okemasis Cree Nation Band, P.O. Box 340, Duck Lake, SK S0K 1J0, Canada
| | - Delano Mike
- Beardy’s & Okemasis Cree Nation Band, P.O. Box 340, Duck Lake, SK S0K 1J0, Canada
| | - Warren Seesequasis
- Willow Cree Health Services, Beardy’s & Okemasis Cree Nation, P.O. Box 96, Duck Lake, SK S0K 1J0, Canada
- Beardy’s & Okemasis Cree Nation Band, P.O. Box 340, Duck Lake, SK S0K 1J0, Canada
| | - Marie Neubuhr
- Willow Cree Health Services, Beardy’s & Okemasis Cree Nation, P.O. Box 96, Duck Lake, SK S0K 1J0, Canada
- Beardy’s & Okemasis Cree Nation Band, P.O. Box 340, Duck Lake, SK S0K 1J0, Canada
| | - Robert Skomro
- Department of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
- Division of Respirology, Critical Care, and Sleep Medicine, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Donna C. Rennie
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Kathleen McMullin
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Brooke P. Russell
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Niels Koehncke
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Sylvia Abonyi
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Malcolm King
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
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16
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Muñoz-Gómez R, Navarrete-Martínez E, Serrano-Merino J, Silva-Gil F, Roldán-Villalobos A, Martín-Rioboó E, Ruiz-Moruno J, Romero-Rodríguez E, Gonzalez-Lama J, Vaquero-Abellán M, Perula-de-Torres LA. The usefulness of the Spanish version of the STOP-Bang questionnaire for screening for moderate or severe sleep apnea syndrome in primary care. Front Public Health 2022; 10:975114. [PMID: 36159274 PMCID: PMC9502031 DOI: 10.3389/fpubh.2022.975114] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/08/2022] [Indexed: 01/25/2023] Open
Abstract
Rationale Sleep apnea-hypopnea syndrome (OSA) is a highly prevalent disease and has been related to cardiovascular diseases and occupational and traffic accidents. Currently, it is estimated that there is a significant underdiagnosis of OSA, mainly due to the difficulty accessing the tests for that purpose. Objective To determine the usefulness of the Spanish version of the STOP-Bang questionnaire (SBQ) for screening for moderate or severe OSA in the adult population attending primary care. Methods A descriptive observational multicenter study was conducted. Through an opportunistic search, (patients over 18 years old), were recruited in seven primary care centers. The SBQ was applied to them and home respiratory polygraphy (HRP) was subsequently performed to confirm the diagnosis of OSA. The criterion validity of the SBQ was analyzed, comparing the score obtained by the SBQ with the apnea-hypopnea index (AHI) obtained by RP, establishing the diagnosis of OSA for an AHI>5. The reliability of the questionnaire was evaluated. Results A total of 255 subjects, 54.1% men, with a mean age of 54.76 ± 10 years, were recruited in the study. The results showed that 61.57% (95% Confidence Interval: 55.57-67.57) of the subjects presented OSA, presenting 22.75% (17.57-57.92) a mild OSA (530) (11.54-20.62). The Kuder and Richardson coefficient was 0.623 (0.335-0.788) and Cohen's Kappa coefficient was 0.871 (0.520-1.00; p < 0.001). For moderate/severe OSA screening (AHI>15) the SBQ obtained an ROC curve of 0.769 (0.704-0.833) that with an optimal cutoff of 3, achieved a sensitivity of 84.85% (77.28-92.42) and a specificity of 55.10% (44.74-65.46). Conclusions The SBQ is very effective for detecting moderate/severe OSA. Its psychometric properties are similar to those obtained in studies on other populations. Because of its ease of use, the SBQ is a very useful tool for primary health care professionals.
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Affiliation(s)
- Rafaela Muñoz-Gómez
- Centro de Salud Sector Sur, Distrito Sanitario Córdoba-Guadalquivir, Distrito Sanitario Córdoba Guadalquivir, Córdoba, Spain,Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain
| | - Esther Navarrete-Martínez
- Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain,Centro de Salud de Marchena, Área de Gestión Sanitaria Osuna-Sureste Sevilla, Sevilla, Spain
| | - Jesús Serrano-Merino
- Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain,Centro de Salud Sector Sur, Distrito Sanitario Córdoba-Guadalquivir, Córdoba, Spain,*Correspondence: Jesús Serrano-Merino
| | - Fátima Silva-Gil
- Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain,Centro de Salud Pedro Abad, Distrito Sanitario Córdoba-Guadalquivir, Córdoba, Spain
| | - Ana Roldán-Villalobos
- Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain,Centro de Salud Castilla del Pino, Distrito Sanitario Córdoba-Guadalquivir, Córdoba, Spain
| | - Enrique Martín-Rioboó
- Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain,Centro de Salud Poniente, Distrito Sanitario Córdoba-Guadalquivir, Córdoba, Spain
| | - Javier Ruiz-Moruno
- Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain,Centro de Salud Aeropuerto, Distrito Sanitario Córdoba-Guadalquivir, Córdoba, Spain
| | - Esperanza Romero-Rodríguez
- Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain,Centro de Salud Castilla del Pino, Distrito Sanitario Córdoba-Guadalquivir, Córdoba, Spain,Unidad docente multiprofesional de atención familiar y comunitaria, Distrito Sanitario Córdoba-Guadalquivir, Córdoba, Spain
| | - Jesus Gonzalez-Lama
- Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain,Centro de Salud de Cabra, Área de Gestión Sanitaria Sur de Córdoba, Córdoba, Spain
| | - Manuel Vaquero-Abellán
- Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain,Facultad de Medicina y Enfermería, Universidad de Córdoba, Cordoba, Spain
| | - Luis Angel Perula-de-Torres
- Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba, Córdoba, Spain,Unidad docente multiprofesional de atención familiar y comunitaria, Distrito Sanitario Córdoba-Guadalquivir, Córdoba, Spain
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Protasiewicz Timofticiuc DC, Vladu IM, Ștefan AG, Clenciu D, Mitrea A, Pădureanu V, Efrem IC, Diaconu ID, Turcu A, Țenea-Cojan TȘ, Hâncu AM, Forțofoiu M, Mirea Munteanu O, Moța M. Associations of Chronic Diabetes Complications and Cardiovascular Risk with the Risk of Obstructive Sleep Apnea in Patients with Type 2 Diabetes. J Clin Med 2022; 11:jcm11154403. [PMID: 35956020 PMCID: PMC9368962 DOI: 10.3390/jcm11154403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/01/2022] [Accepted: 07/26/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Type 2 diabetes mellitus (T2DM) is associated with increased mortality and morbidity, including cardiovascular diseases and obstructive sleep apnea (OSA). The aim of this study was to assess the associations between cardiovascular risk, chronic diabetes complications and the risk of OSA in adult patients with T2DM. Methods: The study included 529 patients with T2DM in whom moderate-to-severe OSA risk was assessed using the STOP-Bang questionnaire, dividing the subjects into two groups: group 1: STOP-Bang score <5, and group 2: STOP-Bang score ≥5, respectively. In all the subjects, cardiovascular risk was assessed using the UKPDS risk engine. Statistical analysis was performed using SPSS 26.0, the results being statistically significant if p value was <0.05. Results: 59% of the subjects scored ≥5 on the STOP-Bang questionnaire. We recorded statistically significant differences between the two groups regarding diabetes duration, HbA1c, HOMA-IR, albuminuria, as well as cardiovascular risk at 10 years for both coronary heart disease (CHD) and stroke (p < 0.05). Furthermore, through logistic regression, adjusting for confounding factors, we demonstrated that the STOP-Bang score ≥ 5 is a risk factor for 10-year fatal and nonfatal CHD risk. Conclusions: It is extremely important to screen and diagnose OSA in patients with T2DM, in order to improve the primary and secondary prevention of cardiovascular events in these patients.
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Affiliation(s)
- Diana Cristina Protasiewicz Timofticiuc
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.C.P.T.); (I.-D.D.); (M.M.)
- Department of Diabetes, Nutrition and Metabolic Diseases, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania
| | - Ionela Mihaela Vladu
- Department of Diabetes, Nutrition and Metabolic Diseases, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania
- Department of Diabetes, Nutrition and Metabolic Diseases, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
- Correspondence: (I.M.V.); (A.M.); (M.F.); Tel.: +40-76367-0811 (I.M.V.); +40-72787-8853 (A.M.); +40-73586-4289 (M.F.)
| | | | - Diana Clenciu
- Department of Diabetes, Nutrition and Metabolic Diseases, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
- Department of Diabetes, Nutrition and Metabolic Diseases, Clinical Municipal Hospital “Philanthropy” of Craiova, 200143 Craiova, Romania
| | - Adina Mitrea
- Department of Diabetes, Nutrition and Metabolic Diseases, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
- Department of Diabetes, Nutrition and Metabolic Diseases, Clinical Municipal Hospital “Philanthropy” of Craiova, 200143 Craiova, Romania
- Correspondence: (I.M.V.); (A.M.); (M.F.); Tel.: +40-76367-0811 (I.M.V.); +40-72787-8853 (A.M.); +40-73586-4289 (M.F.)
| | - Vlad Pădureanu
- Department of Medical Semiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
- Department of Internal Medicine, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania
| | - Ion Cristian Efrem
- Department of Internal Medicine and Medical Semiology, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
- Department of Internal Medicine, Clinical Municipal Hospital “Philanthropy” of Craiova, 200143 Craiova, Romania
| | - Ileana-Diana Diaconu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.C.P.T.); (I.-D.D.); (M.M.)
- Department of Pediatric Pneumology, “Marius Nasta” National Institute of Pneumophtisiology, 050159 Bucharest, Romania
| | - Adina Turcu
- Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
- Infectious Diseases Hospital “Victor Babes”, 200515 Craiova, Romania
| | - Tiberiu Ștefăniță Țenea-Cojan
- Department of General Surgery, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
- Department of General Surgery, C.F. Clinical Hospital, 200374 Craiova, Romania
| | | | - Maria Forțofoiu
- Department of Emergency Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Emergency Medicine, Clinical Municipal Hospital “Philanthropy” of Craiova, 200143 Craiova, Romania
- Correspondence: (I.M.V.); (A.M.); (M.F.); Tel.: +40-76367-0811 (I.M.V.); +40-72787-8853 (A.M.); +40-73586-4289 (M.F.)
| | - Oana Mirea Munteanu
- Department of Cardiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
- Department of Cardiology, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania
| | - Maria Moța
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.C.P.T.); (I.-D.D.); (M.M.)
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Kasmaoui FE, Benksim A, El Harsi EM, Amine M. Prediction models and morbidities associated to obstructive sleep apnea: An updated systematic review. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2022. [DOI: 10.29333/ejgm/12131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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VAGO EL, FRANGE C, DA PAZ OLIVEIRA G, JULIANO ML, MACHADO MA, COELHO FMS. The association between sleep disturbances and tooth loss among post-stroke patients. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:173-179. [DOI: 10.1590/0004-282x-anp-2020-0368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/17/2021] [Accepted: 06/15/2021] [Indexed: 11/21/2022]
Abstract
ABSTRACT Background: Loss of teeth has been associated with neurological and sleep disorders. It is considered to be a predictor of stroke and leads to modifications of airway patency and predisposition to obstructive sleep apnea. Objective: To investigate sleep quality, risk of obstructive sleep apnea and excessive sleepiness among post-stroke patients with tooth loss attending the Neurovascular Clinic of the Federal University of São Paulo. Methods: The prevalence rates of different types of stroke were assessed among 130 patients with different degrees of tooth loss, along with the presence of sleep disturbances, risk of obstructive sleep apnea and excessive daytime sleepiness. Results: The prevalence of ischemic stroke was 94.6%, with either no significant disability or slight disability. Our sample had poor sleep quality, and a high risk of obstructive sleep apnea, but without excessive daytime sleepiness. Half of our sample had lost between 9 and 31 teeth, and more than 25% had edentulism. The majority used full removable dental prostheses, and more than half of these individuals slept without removing the prosthesis. Conclusions: We found high prevalence of poor sleep quality and high risk of obstructive sleep apnea among post-stroke patients with tooth loss. This indicates the need for further studies on treating and preventing sleep disturbances in stroke patients with tooth loss.
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Gumidyala R, Selzer A. Preoperative optimization of obstructive sleep apnea. Int Anesthesiol Clin 2022; 60:24-32. [PMID: 34897219 DOI: 10.1097/aia.0000000000000353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Arnardottir ES, Islind AS, Óskarsdóttir M. The Future of Sleep Measurements: A Review and Perspective. Sleep Med Clin 2021; 16:447-464. [PMID: 34325822 DOI: 10.1016/j.jsmc.2021.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This article provides an overview of the current use, limitations, and future directions of the variety of subjective and objective sleep assessments available. This article argues for various ways and sources of collecting, combining, and using data to enlighten clinical practice and the sleep research of the future. It highlights the prospects of digital management platforms to store and present the data, and the importance of codesign when developing such platforms and other new instruments. It also discusses the abundance of opportunities that data science and machine learning open for the analysis of data.
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Affiliation(s)
- Erna Sif Arnardottir
- Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Menntavegi 1, 102 Reykjavik, Iceland; Internal Medicine Services, Landspitali University Hospital, E7 Fossvogi, 108 Reykjavik, Iceland.
| | - Anna Sigridur Islind
- Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Menntavegi 1, 102 Reykjavik, Iceland; Department of Computer Science, Reykjavik University, Menntavegi 1, 102 Reykjavik, Iceland
| | - María Óskarsdóttir
- Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Menntavegi 1, 102 Reykjavik, Iceland; Department of Computer Science, Reykjavik University, Menntavegi 1, 102 Reykjavik, Iceland
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