In-Home, Self-Assembled Sleep Studies Are Useful in Diagnosing Sleep Apnea in the Elderly
Autor: | Frances M. Pack, Bethany Staley, Greg Maislin, Sharon Hurley, Nalaka S. Gooneratne, Christian R. Morales, Indira Gurubhagavatula, Lindsay C. Wick, Allan I. Pack |
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Rok vydání: | 2012 |
Předmět: |
Male
medicine.medical_specialty Polysomnography Psychological intervention In-Home Self-Assembled Sleep Studies for Diagnosing Sleep Apnea in Elderly Body Mass Index Cohort Studies Sleep Apnea Syndromes Physiology (medical) medicine Humans Prospective Studies Prospective cohort study Geriatric Assessment Aged Philadelphia Receiver operating characteristic medicine.diagnostic_test business.industry Reproducibility of Results Sleep apnea Apnea medicine.disease Obstructive sleep apnea Editorial ROC Curve Area Under Curve Physical therapy Feasibility Studies Female Neurology (clinical) medicine.symptom business Body mass index |
Zdroj: | SLEEP. |
ISSN: | 1550-9109 0161-8105 |
DOI: | 10.5665/sleep.2196 |
Popis: | Objectives Obstructive sleep apnea (OSA) is common and treatable among the elderly. Yet, few older adults seek evaluation for OSA at sleep disorders centers. The authors assessed the feasibility of a two-stage screening procedure for obstructive sleep apnea syndrome (OSAS) in a community-based sample of older adults. Design Prospective cohort study. Setting Participants' domicile (in-home) and academic sleep research center. Participants There were 452 Medicare recipients residing in the greater Philadelphia metropolitan area with the complaint of daytime sleepiness. Interventions None. Measurements and results All participants underwent in-home unattended sleep studies that recorded airflow, and standard in-laboratory polysomnography. Additional measures included symptoms of sleep apnea, body mass index, neck circumference, age, and sex. When comparing diagnostic approaches, the best-performing single-stage model was one that combined apnea symptoms with age and neck circumference. This model had an area under the receiver operating characteristic curve (AUC) of 0.774 and negative posttest probability of 1.2%. The best-performing two-stage model combined symptoms, neck circumference, age, and sex in the first stage, followed by an unattended portable study with a corresponding AUC of 0.85 and negative posttest probability of 0.5%. Conclusions Unattended, self-assembled, in-home sleep studies recording airflow and respiratory effort are most useful if applied in tandem with clinical data, including a carefully obtained sleep history. This two-stage model is accurate in identifying severe OSAS in older adults and represents a practical diagnostic approach for older adults. Incorporating clinical data was vital and increased accuracy well above that of unattended studies of airflow and effort alone. |
Databáze: | OpenAIRE |
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