Questionnaire and Portable Sleep Test Screening of Sleep Disordered Breathing in Acute Stroke and TIA
| Autor: | Thanh N. Nguyen, Helena Lau, Judith Clark, Tatiana Filina, Hesham Masoud, Jose R. Romero, Yelena Pyatkevich, Benjamin K Petrie, Julie G. Shulman, Hugo J. Aparicio, Sanford Auerbach, Tudor Sturzoiu, Saleh Abbas |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Subarachnoid hemorrhage Polysomnography Sleep medicine Article Internal medicine mental disorders medicine Stroke medicine.diagnostic_test business.industry Epworth Sleepiness Scale screening Sleep apnea cerebrovascular disorders General Medicine medicine.disease sleep apnea stroke Confidence interval nervous system diseases respiratory tract diseases Apnea–hypopnea index Medicine business |
| Zdroj: | Journal of Clinical Medicine Volume 10 Issue 16 Journal of Clinical Medicine, Vol 10, Iss 3568, p 3568 (2021) |
| ISSN: | 2077-0383 |
| Popis: | Sleep disordered breathing (SDB) is highly prevalent, but frequently unrecognized among stroke patients. Polysomnography (PSG) is difficult to perform soon after a stroke. We evaluated the use of screening questionnaires and portable sleep testing (PST) for patients with acute stroke, subarachnoid hemorrhage, or transient ischemic attack to expedite SDB diagnosis and management. We performed a single-center retrospective analysis of a quality improvement study on SDB screening of consecutive daytime, weekday, adult admissions to a stroke unit. We excluded patients who were unable to communicate and lacked available family members. Patients were screened with the Epworth Sleepiness Scale, Berlin Questionnaire, and STOP-BANG Questionnaire and underwent overnight PST and/or outpatient PSG. The 4-item STOP Questionnaire was derived from STOP-BANG for a secondary analysis. We compared the sensitivity and specificity of the questionnaires for the diagnosis of at least mild SDB (apnea hypopnea index (AHI) ≥5) on PST and correlated AHI measurements between PST and PSG using the Spearman correlation. Out of sixty-eight patients included in the study, 54 (80%) were diagnosed with SDB. Only one (1.5%) had a previous SDB diagnosis. Thirty-three patients completed all questionnaires and a PST. The STOP-BANG questionnaire had the highest sensitivity for at least mild SDB (0.81, 95% CI (confidence interval): 0.65–0.92) but a low specificity (0.33, 95% CI 0.10, 0.65). The discrimination of all questionnaires was overall poor (C statistic range 0.502–0.640). There was a strong correlation (r = 0.71) between the AHI results estimated using PST and outpatient PSG among 28 patients. The 4-item STOP Questionnaire was the easiest to administer and had a comparable or better sensitivity than the other questionnaires. Inpatient PSTs were useful for screening in the acute setting to facilitate an early diagnosis of SDB and to establish further outpatient evaluations with sleep medicine. |
| Databáze: | OpenAIRE |
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