폐쇄성수면무호흡증의 임상적 예측인자들
Clinical Predictors of Obstructive Sleep Apnea
2
조회
0
다운로드
7
인용
0
참고문헌
초록
Abstract
Background: Obstructive sleep apnea (OSA) is a common sleep disorder that causes daytime dysfunction and cardiovascular diseases. Nocturnal polysomnography (NPSG) is the standard method of evaluating OSA; however, it is time-consuming, inconvenient, and expensive. Selective performance of NPSG would be possible if we could better predict those who are more likely to have clinically significant OSA. The aim of this study is to define clinical and anthropometric predictors of OSA. Methods: We included 100 consecutive patients in whom OSA was clinically suspected. Structured sleep interview, anthropometric measurement, and NPSG were performed in all subjects. Presence of OSA was defined when the apnea-hypopnea index was five or more. Parameters from sleep interview and anthropometric data were investigated with multiple logistic regression using the SAS program (ver 8.1, USA) to identify independent predictors of OSA. Results: OSA was diagnosed in seventy-six patients after NPSG. Univariate analysis showed that the male sex, co-existing diabetes, overweight (BMI≥25), habitual alcohol drinking, large neck circumference (≥40 cm), high waist circumference/hip circumference (WC/HC) ratio (≥0.94), and observed apnea were significantly more frequent in OSA patients (p<0.05). Using multivariate analysis, large neck circumference (≥40 cm) (adjusted OR=4.43, 95% CI: 1.05~18.61) and high WC/HC ratio (adjusted OR=3.48, 95% CI: 1.12~10.80) were found to be the independent predictors of OSA on the NPSG. Conclusions: We report the predictors of OSA that could be easily identified by clinical and anthropometric evaluations before performing NPSG. This might aid the clinical decision whether or not to perform NPSG in subjects with clinically suspected OSA syndrome.
참고문헌 (31)
- "Risk factors for obstructive sleep apnea in adults", 291, pp.2013~2016 (2004)
- "Epidemiology of obstructive sleep apnea:a population health perspective", 165, pp.1217~1239 (2002)
- "Obstructive sleep apnea:implications for cardiac and vascular disease", 290, pp.1906~1914 (2003)
- "Obstructive sleep apnea", 39, pp.517~567 (1994)
- "Using self-reported questionnaire data to prioritize OSA patients for polysomnography", 20, pp.232~236 (1997)
- "An algorithm to stratify sleep apnea risk in a sleep disorders clinic population", 164, pp.1904~1909 (2001)
- "Likelihood ratios for a sleep apnea clinical prediction rule", 150, pp.1279~1285 (1994)
- "Predicting sleep apnea and excessive day sleepiness in the severely obese:indicators for polysomnography", 123, pp.1134~1141 (2003)
- "A survey screen for prediction of apnea", 18, pp.158~166 (1995)
- "A predictive morphometric model for the obstructive sleep apnea syndrome", 127, pp.581~587 (1997)
- "Prospective testing of two models based on clinical and oximetric variables for prediction of obstructive sleep apnea", 121, pp.747~752 (2002)
- "Predictors of sleep-disordered breathing in community-dwelling adults:the Sleep Heart Health Study", 162, pp.893~900 (2002)
- "A new method for measuring daytime sleepiness:the Epworth sleepiness scale", 14, pp.540~545 (1991)
- "Accuracy of self-measurement of body fat distribution by waist,hip,and thigh circumferences", 15, pp.179~186 (1991)
- "A manual of standardized technology techniques and scoring system for sleep stages of human subjects University of California-Los angeles" (1968)
- "a preliminary report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association", pp.173~184
- "Sleep-related breathing disorders in adults:recommendations for syndrome definition and measurement techniques in clinical research", 22, pp.667~689 (1999)
- "Longitudinal study of moderate weight change and sleep- disordered breathing", 284, pp.3015~3021 (2000)
- "Neck circumference and other clinical features in the diagnosis of the obstructive", pp.101~105
- "The relationship between craniofacial morphology and obstructive sleep apnea in whites and in African-americans", 163, pp.947~950 (2001)
- "Obesity and weight loss in obstructive sleep apnea:a critical review", 19, pp.104~115 (1996)
- "Physical findings and the risk for obstructive sleep apnea:the importance of oropharyngeal structures", 162, pp.740~748 (2000)
- "Obstructive sleep apnea-hypopnea syndrome", 78, pp.1545~1552 (2003)
- "Cephalometric comparisons between Chinese and Caucasian patients with obstructive sleep apnea", 117, pp.479~485 (2000)
- "upper airway assessment and physical examination", 31, pp.919~930 (1998)
- "Obstructive sleep apnea syndrome:a comparison between Far-East Asian and white men", 110, pp.1689~1693 (2000)
- "Nasal obstruction in sleep-disordered breathing", 36, pp.437~460 (2003)
- "Alcohol increases sleep apnea and oxygen desaturation in asymptomatic men", 71, pp.240~245 (1981)
- "Smoking as a risk factor for sleep-disordered breathing", 154, pp.2219~2224 (1994)
- "Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome", 131, pp.485~491 (1999)
- "A decision rule for diagnostic testing in obstructive sleep apnea", 167, pp.1427~1432 (2003)
