Wednesday, November 3, 2010

Loyola Study Finds 80.5% of Hospital Patients Are at High Risk for Sleep Apnea

MAYWOOD, Ill. -- Eighty-one percent of hospital patients are at high risk for obstructive sleep apnea, a Loyola University Health System study has found.

The findings suggest that hospitals should consider giving patients a five-minute screening test to identify those who are at high risk.

Sleep specialist Dr. Sunita Kumar and colleagues administered an eight-question obstructive sleep apnea screening questionnaire known as STOP-BANG to patients during a single day at Loyola University Hospital. Patients were excluded if they were on a breathing tube, on sedatives or had an altered mental status.

Of the 195 patients surveyed, 157, or 80.5 percent, were at high risk for obstructive sleep apnea, meaning they answered "Yes" to at least three questions on the questionnaire.

Kumar reported results during Chest 2010, the annual meeting of the American College of Chest Physicians in Vancouver, Canada.

During obstructive sleep apnea, breathing pauses as often as 30 times an hour, causing poor sleep quality and excessive daytime sleepiness. About 5 percent of the general population is reported to have obstructive sleep apnea. The prevalence is likely higher due to increasing obesity.

Little data exist on the prevalence of obstructive sleep apnea in hospitalized patients. Obstructive sleep apnea can increase the risk of high blood pressure, heart attack, stroke, obesity, diabetes, heart failure and arrhythmias (irregular heartbeats).

While 157 patients in the study were at high risk for apnea, only 41 had been evaluated in an overnight sleep lab. Of those 41 patients, 31 had been diagnosed with obstructive sleep apnea. But only 18 were being treated, either with a Continuous Positive Airway Pressure breathing mask (17 patients) or surgery (1 patient).

"Undiagnosed obstructive sleep apnea may be associated with increased risk of complications in hospitalized patients," Kumar and colleagues reported. "Screening and evaluation for obstructive sleep apnea in high-risk patients should be considered as it may help reduce the burden of undiagnosed obstructive sleep apnea."

Kumar is an assistant professor in the Division of Pulmonary and Critical Care Medicine at Loyola University Chicago Stritch School of Medicine. Her co-authors, all Loyola fellows in pulmonary and critical-care medicine, are Dr. David McElligott, Dr. Amit Goyal, Dr. Matthew Baugh and Dr. Ramona Ionita.

The STOP-BANG questionnaire consists of eight questions:

Do you Snore loudly? Are you Tired or sleepy during the day? Has anyone Observed you stop breathing during sleep? Do you have high blood Pressure? Do you have a Body mass index higher than 35. (Depending on height, this means being approximately 65 to 70 pounds or more overweight). Is your Age older than 50? Do you have a Neck circumference greater than 40 cm (15.7 inches)? Is your Gender male?

A score of 3 or more “Yes” answers is considered a high risk for obstructive sleep apnea.

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About Loyola University Health System

Loyola University Health System (LUHS) is part of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. Loyola University Medical Center’s campus is conveniently located in Maywood, 13 miles west of Chicago’s Loop and 8 miles east of Oak Brook, Ill. At the heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola's Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

Trinity Health is a national Catholic health system with an enduring legacy and a steadfast mission to be a transforming and healing presence within the communities we serve. Trinity is committed to being a people-centered health care system that enables better health, better care and lower costs. Trinity Health has 88 hospitals and hundreds of continuing care facilities, home care agencies and outpatient centers in 21 states and 119,000 employees.