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Namen AM, Forest D, Saha AK, Xiang KR, Younger K, Maurer S, Ahmad Z, Chatterjee AB, O’Donovan C, Sy A, Peters SP, Haponik EF. DOISNORE50: a perioperative sleep questionnaire predictive of obstructive sleep apnea and postoperative medical emergency team activation. A learning health system approach to sleep questionnaire development and screening. J Clin Sleep Med 2022; 18:1909-1919. [PMID: 35499151 PMCID: PMC9340585 DOI: 10.5664/jcsm.10006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Patients with obstructive sleep apnea (OSA) have a disproportionate increase in postoperative complications and medical emergency team activation (META). We previously introduced DOISNORE50 (Diseases, Observed apnea, Insomnia, Snoring, Neck circumference > 18 inches, Obesity with BMI > 32, R = are you male, Excessive daytime sleepiness, 50 = age ≥ 50) from sleep questionnaire ISNORED using features associated with increased odds of META in perioperative patients. Performance of DOISNORE50 (DOISNORE) had yet to be tested. METHODS The performance of DOISNORE was tested along with questionnaire ISNORED and STOP-BANG questionnaires among 300 out of 392 participants without known OSA referred to the sleep lab. In study 2, the performance of DOISNORE was tested among 64,949 lives screened in perioperative assessment clinic from 2016 to 2020. RESULTS Receiver operating characteristic curve demonstrated that best performance was achieved with responses, with area under curve of 0.801. DOISNORE's predictability of OSA risk remained stable from 2018 to 2020 with area under curve of 0.78 and a Cronbach alpha of 0.65. Patients at high risk for OSA (DOISNORE ≥ 6) were associated with an increase of META (odds ratio 1.30, 95% confidence interval 1.12-1.45). Higher relative risk was noted among patients with congestive heart failure and hypercapnia. CONCLUSIONS DOISNORE is predictive of OSA and postoperative META. Perioperative strategies against META should consider DOISNORE questionnaire and focused screening among patients with heart failure and hypercapnia. CITATION Namen AM, Forest D, Saha AK, et al. DOISNORE50: a perioperative sleep questionnaire predictive of obstructive sleep apnea and postoperative medical emergency team activation. A learning health system approach to sleep questionnaire development and screening. J Clin Sleep Med. 2022;18(8):1909-1919.
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Affiliation(s)
- Andrew M. Namen
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina,Address correspondence to: Andrew M. Namen, MD, Atrium Health Wake Forest Baptist Medical Center Blvd., Winston–Salem, NC 27006; Tel: (336) 716-4649;
| | | | - Amit K. Saha
- Department of Anesthesiology and Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Kang Rui Xiang
- Section on Pulmonary Critical Care and Allergy and Immunologic Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | | | - Sheila Maurer
- Section on Pulmonary Critical Care and Allergy and Immunologic Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Zeeshan Ahmad
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Arjun B. Chatterjee
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Cormac O’Donovan
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Alexander Sy
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Stephen P. Peters
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Edward F. Haponik
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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Umar A, Khan MS, Sehgal SA, Jafar K, Ahmad S, Waheed A, Aslam MW, Wajid M, Rehman TU, Khan T, Ditta A, Akmal H, Ashfaq M, Javed T, Tahir R. Epidemiological studies of sleep disorder in educational community of Pakistani population, its major risk factors and associated diseases. PLoS One 2022; 17:e0266739. [PMID: 35446890 PMCID: PMC9022811 DOI: 10.1371/journal.pone.0266739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/25/2022] [Indexed: 11/18/2022] Open
Abstract
Sleep is one of the most important functions of the life. The disturbance in sleep or quality of sleep leads to several dysfunctions of the human body. This study aimed to investigate the prevalence of sleep disorders, their possible risk factors and their association with other health problems. The data was collected from the educational community of the Pakistani population. The Insomnia Severity Index (ISI) was used to evaluate the insomnia and the sleep apnea was evaluated through a simple questionnaire method. The blood samples were collected to perform significant blood tests for clinical investigations. Current research revealed that the individuals in the educational community had poor sleep quality. A total of 1998 individuals from the educational community were surveyed, 1584 (79.28%) of whom had a sleep disorders, including insomnia (45.20%) and sleep apnea (34.08%). The measured onset of age for males and females was 30.35 years and 31.07 years respectively. The Clinical investigations showed that the sleep had significant impact on the hematology of the patients. Higher levels of serum uric acid and blood sugar were recorded with a sleep disorder. The individuals of the educational community were using the sleeping pills. The other associated diseases were mild tension, headaches, migraines, depression, diabetes, obesity, and myopia. The use of beverage, bad mood, medical condition, mental stress, disturbed circadian rhythms, workload and extra use of smartphone were major risk factors of sleep disorders. It was concluded that the insomnia was more prevalent than the sleep apnea. Furthermore, life changes events were directly linked with disturbance of sleep. Tension, depression, headaches, and migraine were more associated with sleep disorders than all other health issues.
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Affiliation(s)
- Ali Umar
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Muhammad Saleem Khan
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
- * E-mail: (MSK); (SAS)
| | - Sheikh Arslan Sehgal
- Department of Bioinformatics, Faculty of Life Sciences, University of Okara, Okara, Pakistan
- * E-mail: (MSK); (SAS)
| | - Kamran Jafar
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Shabbir Ahmad
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Ahmad Waheed
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Muhammad Waseem Aslam
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Muhammad Wajid
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Tanzil Ur Rehman
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Tehmina Khan
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Allah Ditta
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Hasnain Akmal
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Muhammad Ashfaq
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Tariq Javed
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Rida Tahir
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
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Gumidyala R, Selzer A. Preoperative optimization of obstructive sleep apnea. Int Anesthesiol Clin 2022; 60:24-32. [PMID: 34897219 DOI: 10.1097/aia.0000000000000353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Soori R, D’Sa I, Hosmane G. The Utility of Epworth Sleepiness Scale to Screen Moderate and Severe Obstructive Sleep Apnea Preoperatively to Predict Difficult Airway. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2021. [DOI: 10.1055/s-0041-1722823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Abstract
Introduction Obstructive sleep apnea (OSA) is sleep-disordered breathing characterized by repetitive episodes of partial or complete upper airway collapse in sleep leading to apnea and/or hypopnea, desaturations, sleep disruptions, and cardiovascular changes. OSA is a known cause for difficult airway, especially mask ventilation. Daytime sleepiness is one of the hallmark symptoms of OSA. So, we used the Epworth sleepiness score (ESS) in patients suspected of OSA undergoing a sleep study.
Methods Overall, 44 subjects suspected to have OSA and undergoing polysomnography were included in the study. The socio-demographic details and the complaints were recorded and the Epworth sleepiness questionnaire was administered. The severity of OSA was graded as per the American Academy of Sleep Medicine using the apnea hypopnea index.
Results A total of 44 patients were included in the study. Out of these, 19 were mild, 13 moderate, and 12 severe OSA cases, respectively. ESS of more than 10 showed a positive predictive value of 81.25% and specificity of 85% in screening patients with moderate and severe OSA. But the sensitivity and negative predictive value was only 54.16 and 60.71%, respectively.
Conclusion ESS being a simple questionnaire can be easily used preoperatively. A score of more than 10 effectively diagnoses moderate and severe OSA, but less than 10 cannot rule out OSA
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Affiliation(s)
- Rashmi Soori
- Department of Anaesthesiology, K.S. Hegde Medical Academy, Deralakatte, Mangaluru, Karnataka, India
| | - Ivor D’Sa
- Department of General Medicine, K.S. Hegde Medical Academy, Deralakatte, Mangaluru, Karnataka, India
| | - Giridhar Hosmane
- Department of Pulmonary Medicine, K.S. Hegde Medical Academy, Deralakatte, Mangaluru, Karnataka, India
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