Risk of sleep apnea in hospitalized older patients.
BACKGROUND/OBJECTIVES
To assess the prevalence of undiagnosed obstructive sleep apnea (OSA) among general medical inpatients and to investigate whether OSA risk is associated with in-hospital sleep quantity and quality.


DESIGN
Prospective cohort study.


SETTING
General medicine ward in academic medical center.


PARTICIPANTS
424 hospitalized adult patients ≥ 50 years old without a sleep disorder diagnosis (mean age 65 years, 57% female, 72% African American).


MAIN MEASURES
The Berlin questionnaire, a validated screen for determining risk of OSA, was administered to hospitalized medical patients. Sleep duration and efficiency were measured via wrist actigraphy. Self-reported sleep quality was evaluated using Karolinska Sleep Quality Index (KSQI).


KEY RESULTS
Two of every 5 inpatients ≥ 50 years old (39.5%, n = 168) were found to be at high risk for OSA. Mean in-hospital sleep duration was ∼ 5 h and mean sleep efficiency was 70%. Using random effects linear regression models, we found that patients who screened at high risk for OSA obtained ∼ 40 min less sleep per night (-39.6 min [-66.5, -12.8], p = 0.004). These findings remained significant after controlling for African American race, sex, and age quartiles. In similar models, those patients who screened at high risk had ∼ 5.5% less sleep efficiency per night (-5.50 [-9.96, -1.05], p = 0.015). In multivariate analysis, patients at high risk for OSA also had lower self-reported sleep quality on KSQI (-0.101 [-0.164, -0.037], p = 0.002).


CONCLUSION
Two of every 5 inpatients older than 50 years screened at high risk for OSA. Those screening at high risk have worse in-hospital sleep quantity and quality.


COMMENTARY
A commentary on this article appears in this issue on page 1067.
['Shear|Talia C|TC|', 'Balachandran|Jay S|JS|', 'Mokhlesi|Babak|B|', 'Spampinato|Lisa M|LM|', 'Knutson|Kristen L|KL|', 'Meltzer|David O|DO|', 'Arora|Vineet M|VM|']
D000368:Aged D002641:Chicago D015331:Cohort Studies D005260:Female D015577:Geriatric Assessment D006801:Humans D008297:Male D017286:Polysomnography D015995:Prevalence D011446:Prospective Studies D018570:Risk Assessment D012307:Risk Factors D012891:Sleep Apnea Syndromes D011795:Surveys and Questionnaires
sleep obstructive sleep apnea hospitalized patients