Questionnaire and Portable Sleep Test Screening of Sleep Disordered Breathing in Acute Stroke and TIA.
Questionnaire and Portable Sleep Test Screening of Sleep Disordered Breathing in Acute Stroke and TIA.
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DOI：
10.3390/jcm10163568
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发表时间：
2021-08-13
影响因子：
3.9
通讯作者：
Aparicio HJ
中科院分区：
文献类型：
--
作者：
Petrie BK;Sturzoiu T;Shulman J;Abbas S;Masoud H;Romero JR;Filina T;Nguyen TN;Lau H;Clark J;Auerbach S;Pyatkevich YG;Aparicio HJ
睡眠呼吸障碍（SDB）是非常普遍的，但经常被忽视的中风患者。多导睡眠图（PSG）在中风后很难立即进行。我们评估了筛查问卷和便携式睡眠测试（PST）在急性卒中、蛛网膜下腔出血或短暂性脑缺血发作患者中的应用，以加快SDB的诊断和治疗。我们对一项关于SDB筛查的质量改进研究进行了单中心回顾性分析，该研究对连续白天、工作日、入住卒中单元的成人进行了SDB筛查。我们排除了无法沟通和缺乏可用家庭成员的患者。采用埃普沃思嗜睡量表、柏林问卷和STOP-BANG问卷对患者进行筛选，并接受夜间PST和/或门诊PSG。4项STOP问卷来自STOP-BANG，用于二次分析。我们使用斯皮尔曼相关性比较了问卷调查对PST诊断至少轻度SDB（呼吸暂停低通气指数（AHI）≥5）的敏感性和特异性，以及PST和PSG之间的相关AHI测量值。在纳入研究的68例患者中，54例（80%）被诊断为SDB。只有1例患者（1.5%）曾有SDB诊断。33例患者完成了所有问卷和PST。STOP-BANG问卷对至少轻度SDB的敏感性最高（0.81，95% CI（置信区间）：0.65-0.92），但特异性较低（0.33，95% CI 0.10，0.65）。所有问卷的区分度总体较差（C统计范围0.502-0.640）。28例患者中，使用PST和门诊PSG估计的AHI结果之间存在强相关性（r = 0.71）。4项STOP问卷最容易管理，与其他问卷相比具有相当或更高的灵敏度。住院患者的PST是有用的筛选在急性设置，以促进SDB的早期诊断，并建立进一步的门诊评估与睡眠药物。
Sleep disordered breathing (SDB) is highly prevalent, but frequently unrecognized among stroke patients. Polysomnography (PSG) is difficult to perform soon after a stroke. We evaluated the use of screening questionnaires and portable sleep testing (PST) for patients with acute stroke, subarachnoid hemorrhage, or transient ischemic attack to expedite SDB diagnosis and management. We performed a single-center retrospective analysis of a quality improvement study on SDB screening of consecutive daytime, weekday, adult admissions to a stroke unit. We excluded patients who were unable to communicate and lacked available family members. Patients were screened with the Epworth Sleepiness Scale, Berlin Questionnaire, and STOP-BANG Questionnaire and underwent overnight PST and/or outpatient PSG. The 4-item STOP Questionnaire was derived from STOP-BANG for a secondary analysis. We compared the sensitivity and specificity of the questionnaires for the diagnosis of at least mild SDB (apnea hypopnea index (AHI) ≥5) on PST and correlated AHI measurements between PST and PSG using the Spearman correlation. Out of sixty-eight patients included in the study, 54 (80%) were diagnosed with SDB. Only one (1.5%) had a previous SDB diagnosis. Thirty-three patients completed all questionnaires and a PST. The STOP-BANG questionnaire had the highest sensitivity for at least mild SDB (0.81, 95% CI (confidence interval): 0.65–0.92) but a low specificity (0.33, 95% CI 0.10, 0.65). The discrimination of all questionnaires was overall poor (C statistic range 0.502–0.640). There was a strong correlation (r = 0.71) between the AHI results estimated using PST and outpatient PSG among 28 patients. The 4-item STOP Questionnaire was the easiest to administer and had a comparable or better sensitivity than the other questionnaires. Inpatient PSTs were useful for screening in the acute setting to facilitate an early diagnosis of SDB and to establish further outpatient evaluations with sleep medicine.
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影响因子：
158.5
作者：
YOUNG, T;PALTA, M;BADR, S
通讯作者：
BADR, S
影响因子：
9.9
作者：
Brill, Anne-Kathrin;Horvath, Thomas;Bassetti, Claudio L.
通讯作者：
Bassetti, Claudio L.
影响因子：
4.3
作者：
Berry, Richard B.;Budhiraja, Rohit;Tangredi, Michelle M.
通讯作者：
Tangredi, Michelle M.
影响因子：
4.3
作者：
Kapur, Vishesh K.;Auckley, Dennis H.;Harrod, Christopher G.
通讯作者：
Harrod, Christopher G.
影响因子：
3.7
作者：
Nagappa M;Liao P;Wong J;Auckley D;Ramachandran SK;Memtsoudis S;Mokhlesi B;Chung F
通讯作者：
Chung F