SESSION TITLE: Sleep Posters I
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM
PURPOSE: Predictors of obstructive sleep apnea (OSA) based on laboratory PSG outcomes are well-known/quantified and include increased adiposity and age, male sex, cardiometabolic disease, and snoring/witnessed apneas. However, it is less well-understood how some of these risk factors used to predict OSA align with outcomes from at-home diagnostic testing using portable recording (PR). We present here predictors of OSA from the largest-to-date clinical sample of patients using a PR for the home-diagnosis of sleep disordered breathing.
METHODS: The SleepMed Apnea Risk Evaluation System (ARES) includes a forehead-worn unicorder and integrated pre-test screening questionnaire which assesses self-reported symptoms of OSA, anthropomorphic indices, and common comorbid medical conditions. Data were obtained from 200, 421 adult patients (59% male) from across North America tested between 2009 and 2013. Multiple logistic regression was employed to predict the odds (odds ratio; OR) of having a positive PR outcome (apnea hypopnea index; AHI>5) across the following factors: neck circumference, age (>50), sleepiness (Epworth Sleepiness Scale score >12), obesity (BMI >30), sex, diabetes, stroke, and hypertension.
RESULTS: The inclusive model was significant, χ2 (7, n=200,421)=26710.4,p<.001 and accounted for 19.2% of the variance in OSA. With the exception of stroke, all variables explained unique variance in PR outcome: age>50 (OR=4.05; 66.7% vs. 35.8%; p<.001), male sex (OR=1.59; 62.9% vs. 46.5%; p<.001), obesity (OR=1.49; 57.5% vs. 44.8%; p<.001), hypertension (OR=1.41; 51.6% vs. 31.7%), neck circumference (OR=1.26; p<.001), sleepiness (OR=1.16; 29.8% vs. 28.6%;p<.001), and diabetes (OR=1.04; 18.5% vs. 10.7%; p<.05). Sex was a statistical moderator between age and PR outcome (p<.001); females were more likely than males (OR: 5.1 vs. 3.3) to have a positive test result after the age of 50.
CONCLUSIONS: Predictors of OSA using unattended PR appear to be similar to those that predict OSA using traditional attended studies. The finding that sex moderated the age-related risk for OSA has been reported previously and may be due to age-related changes in female sex hormones. Future analyses will quantify how self-reported symptoms of OSA (snoring, gasping) strengthen predicative capability.
CLINICAL IMPLICATIONS: Of demographic, anthropomorphic, and medical variables, advancing age (>50 years), especially in females, is the single best predictor of sleep apnea based on home-based testing.
DISCLOSURE: Alyssa Cairns: Employee: Full-time employee of SleepMed, Inc.- the owner of the ARES device Joanne Turner: Employee: Full-time employee of SleepMed, Inc.- the owner of the ARES device Greg Poulos: Employee: Full-time employee of SleepMed, Inc.- the owner of the ARES device Richard Bogan: Employee: Full-time employee of SleepMed, Inc.- the owner of the ARES device
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