PURPOSE: The perioperative management of surgery patients can be seriously complicated by Sleep Disordered Breathing (SDB). Sleep questionnaires are sometimes used to identify patients suspected of SDB before surgery; however, the reliability of these questionnaires in cardiac surgery patients has not been investigated. The purpose behind this study is to assess the reliability of sleep questionnaires in detecting SDB in cardiac surgery patients pre-operatively.
METHODS: Four types of sleep disorders questionnaires (GSAQ, ESS, SA/SDQ, Berlin) followed by polysomnography (PSG) were collected pre-operatively from 100 patients admitted for Coronary Artery Bypass Graft (CABG) or valve replacement at the Cleveland Clinic (CC) and Johns Hopkins Hospital (JHH). Examination of the first three questionnaire types was done (GSAQ, ESS, SA/SDQ). Preliminary analysis was focused on improving Sensitivity results due to the high prevalence of SDB in this surgical population as shown by prior research from this group. Further investigation of the Receiver Operating Characteristics to optimize sensitivity and specificity is underway.
RESULTS: Analysis using SA/SDQ with previously suggested cutoffs of 36 for men and 32 for women showed very weak ability to detect the disease (AHI>5). Sensitivity and specificity were 37%, 70% for men and 38%, 53% for women. Sensitivity improved with cutoffs of 29 for men (sensitivity=78%, specificity=30%) and 26 for women (sensitivity=72%, specificity=40%). Disease severity analysis showed that all three questionnaires were poorly correlated with AHI as measured by PSG; GSAQ (R2=0.0012), ESS (R2=0.0003), and SA/SDQ (R2=0.0348).
CONCLUSIONS: Preliminary analysis suggests a very limited role of sleep questionnaires in detecting SDB or distinguishing disease severity in the cardiac surgery population.
CLINICAL IMPLICATIONS: PSG remains the recommended method to diagnose SDB in cardiac surgery patients.
DISCLOSURE: Nancy Collop: Grant monies (from industry related sources): Funding for the project came from NIH/SBIR grant (CleveMed was the PI on the grant)
Nancy Foldvary-Schaefer: Grant monies (from industry related sources): Project funding came from NIH/SBIR grant (CleveMed was PI on the grant)
Roop Kaw: Grant monies (from industry related sources): Project funding came from NIH/SBIR grant (CleveMed was PI on the grant)
Sarah Weimer: Employee: Employee of CleveMed
Hani Kayyali: Employee: Employee of CleveMed
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