Sleep-Disordered Breathing in Fatigued Postpoliomyelitis Clinic Patients
Presented in part to the American Academy of Physical Medicine and Rehabilitation, October 28, 2005, Philadelphia, PA.
Abstract
Dahan V, Kimoff RJ, Petrof BJ, Benedetti A, Diorio D, Trojan DA. Sleep-disordered breathing in fatigued postpoliomyelitis clinic patients.
Objective
To determine the frequency, predictive factors, and symptoms predictive of sleep-disordered breathing (SDB) in fatigued postpoliomyelitis clinic patients.
Design
Cross-sectional, retrospective chart review.
Setting
University-affiliated hospital postpolio clinic.
Participants
Postpolio clinic charts (N=590) were reviewed. Ninety-eight patients were included, and 492 patients were not included, primarily because of the lack of a polysomnogram.
Interventions
Not applicable.
Main Outcome Measure
The Apnea-Hypopnea Index (AHI) calculated as the total number of sleep-related breathing events/total sleep time.
Results
The frequency of SDB defined by an AHI score of 5 or more was 65% and by an AHI score of 10 or more was 50%. Obstructive hypopnea was the predominant form, occurring in 86%. Age, sex, age at acute polio, time since polio, weakness and respiratory difficulties at acute polio, bulbar involvement at acute polio and at evaluation, body mass index, pulmonary function measures, alcohol use, sedative drug use, smoking, fibromyalgia, kyphoscoliosis, and scoliosis and ear-nose-throat surgery were not predictive of SDB (AHI scores ≥5 and ≥10). Snoring was more common in subjects with SDB (AHI score ≥5 and ≥10). Some pulmonary function measures correlated with oxygen saturation during sleep in SDB (AHI scores ≥5).
Conclusions
SDB was very common in fatigued postpoliomyelitis clinic patients referred for sleep evaluation. Obstructive hypopnea was the most frequent type. In this preliminary study, snoring tended to predict SDB.
aDepartment of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill, University Health Centre, McGill University, Montreal, QC, Canada
bRespiratory Division and Sleep Laboratory, McGill University Health Centre, McGill University, Montreal, Canada
cDepartments of Medicine and Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
dDepartment of Medicine, University of Montreal, Montreal, QC, Canada.
Correspondence to Daria A. Trojan, MD, Montreal Neurological Hospital, McGill University Health Centre, 3801 University St, Montreal, QC H3A 2B4, Canada
Supported by the Polio Quebec Association and the Montreal Neurological Institute (salary support).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT