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In-home, self-assembled sleep studies are useful in diagnosing sleep apnea in the elderly.

Authors
Morales-CR; Hurley-S; Wick-LC; Staley-B; Pack-FM; Gooneratne-NS; Maislin-G; Pack-A; Gurubhagavatula-I
Source
Sleep 2012 Nov; 35(11):1491-1501
NIOSHTIC No.
20042669
Abstract
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.
Keywords
Sleep-deprivation; Sleep-disorders; Age-groups; Humans; Men; Women; Screening-programs; Author Keywords: Aged adults; obstructive sleep apnea; portable sleep studies; screening
Contact
Indira Gurubhagavatula, MD, Center for Sleep and Circadian Neurobiology, 3624 Market Street, Suite 205, Philadelphia, PA 19104
CODEN
SLEED6
Publication Date
20121101
Document Type
Journal Article
Email Address
gu-rubhag@mail.upenn.edu
Funding Type
Grant
Fiscal Year
2013
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-009149
Issue of Publication
11
ISSN
0161-8105
Source Name
Sleep
State
PA
Performing Organization
University of Pennsylvania
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