SESSION TYPE: Sleep Posters
PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM
PURPOSE: Sleep apnea is under diagnosed. Outpatient screening for obstructive sleep apnea (OSA) is not routine. Hospitalized medical patients commonly have diagnoses associated with OSA (i.e. cardiovascular disease, diabetes). Limited survey data suggests >50% of medically hospitalized patients are at-risk for OSA. Identifying OSA in-hospital could impact patient safety and long-term health. We hypothesized that sleep disordered breathing would be highly prevalent in unselected medical inpatients.
METHODS: This is a prospective study enrolling 100 unselected patients admitted directly to the medical floors of an urban academic medical center (MetroHealth Medical Center, Cleveland, OH). Enrollment criteria: between 18 and 65 years old, no prior history of OSA or tracheostomy, willing to undergo in-patient polysomnogram (PSG). Enrolled patients complete OSA screening questionnaires and undergo full-night attended inpatient PSG within 48 hours of admission. This abstract reports preliminary data.
RESULTS: Of 18 patients enrolled to date, 3 were excluded from data analysis: insufficient sleep (< 100 minutes, 2), technique limitations (1). Demographics on the remaining 15 patients: age 51.6 +/- 5.7 years old, 53% male, BMI 31.6 +/- 7 kg/m2. Admission diagnoses: GI-related - 6 patients, COPD/pneumonia - 4 patients, TIA - 2 patients, chest pain / CHF - 2 patients, pancytopenia - 1 patient. PSG sleep data: sleep latency 66.6 +/- 86.4 minutes, sleep efficiency 57.4% +/- 23.4%, SWS absent in 10 (66%) patients, average REM percentage 14.5% +/- 11.1%. PSG respiratory data: 14 of 15 (93%) patients have an AHI > 5 (5 with mild OSA = AHI 5-15, 6 with moderate OSA = AHI 15-30, 3 with severe OSA = AHI > 30), SpO2 < 88% during sleep was noted in 9 (60%) patients, averaging 10.3 +/- 29 minutes. One subject had predominantly central apnea.
CONCLUSIONS: Preliminary data from this ongoing study suggest that previously unrecognized sleep disordered breathing is highly prevalent in unselected hospitalized medical patients. Sleep is generally poor in-hospital.
CLINICAL IMPLICATIONS: Inpatient medical admissions present an opportunity to identify a condition with potential short and long-term health consequences.
DISCLOSURE: Dennis Auckley: Grant monies (from industry related sources): Investigator-iniated grant funding from Cephalon, Grant monies (from industry related sources): Research equipment from ResMed
The following authors have nothing to disclose: Bashar Salem, Cindy Newman
No Product/Research Disclosure InformationMetroHealth Medical Center, CWRU, Cleveland, OH