We evaluated the efficacy of an abbreviated sleep questionnaire, desgined to recognize sleep disordered breathing (SDB)in a cohort of patients assigned to a VA heart failure clinic.
A 6 point data set consisting of (1)Excessive Daytime Sleepiness,(2) Snoring, (3)Observed Apneas,(4) Non-restorative sleep, (5)BMI, (6)and Neck Circumference were collected. Each positive response was given one point. BMI>30 and Neck Circumference>17.5 in were given one point each. Scores of 3 or more points were placed in the high probability category and were assigned high priority for SDB evaluation. Two or less point scores were assigned to the Low probability. All were scheduled for Attended Polysomnography.
Of the 40 heart failure clinic patients evaluated 25 had scores of 3 or more points on the screening questionnaire. 15 patients had 2 or less points and were referred to the VA sleep clinic for confirmatory examination. Four of those 15 patients were referred for polysomnography while the remainder were felt unlikely to have significant SDB. All high probablity patients were scheduled for polyomnography. Sleep Disordered Breathing was identified in 70 per cent of those patients.
The 6 point screening questionnaire appeared to delineate a higher risk group for sleep disordered breathing in this cohort of patients with known heart failure. Less than 30 per cent of the low probability cohort were ultimately studied.
SDB is present in approximately 50 percent of patients with known stable CHF. A short simplified 6 point data set appeared to be sensitive in selecting patients with a high probability for SDB. Use of the questionnaire should identify patients at risk for SDB earlier, and could prioritize their early evaluation and should result in earlier treatment.
John Roehrs, None.Variable (mean ± SD)Simple Obesity (n=64)Obesity Hypoventilation Syndrome (n=12)Age54.2±12.952.5±13.4Body mass index (kg/m2) Pulmonary Function (% predicted) FEV-1 FVC FEV-1/FVC TLC ERV DLCO43.5±9.348.3±10.2 FEV-181±1677±15 FVC82±1577∓15 FEV-1/FVC80±581±5 TLC88±1287±13 ERV48±3737±21 DLCO85±2285±14Arterial blood gases pH7.41±0.037.39±0.02* PaO276±969±12* PaCO239.5±348.4±6.6*Polysomnogram n (%)20 (31)1 (8) Apnea-hypopnea index ≥ 5 (n)131*
p-value < 0.05