Sleep disordered breathing in hospitalized patients

Abstract

Study objective: There is a relatively small body of literature looking at sleep disordered breathing (SDB) in acutely ill inpatients. The aim of this study was to assess the frequency of SDB in acutely ill patients admitted to tertiary care centers referred for an inpatient polysomnogram and to identify associations between SDB and patient characteristics.

Methods: The study was a retrospective chart review of 100 polysomnograms and medical records of all patients who had polysomnography while hospitalized at 2 tertiary care centers between January 2003 and September 2004. Main outcome measures included the frequency of and the association between SDB and specific characteristics, including age, sex, body mass index, and admission disease condition.

Results: There was a high frequency of SDB in the sample (77%). There was an increase in the odds ratio (OR) of SDB with increasing body mass index (OR 1.08; 95% confidence interval; 95% CI 1.02, 1.15). Increasing BMI categories were associated with more severe SDB (p = 0.005). Adjusting for age and BMI, men had a reduced OR of sleep apnea, as compared with women (OR 0.32; 95% CI 0.10, 1.0), and women with SDB were more likely to have more severe disease than men (p = 0.003). There was a significant association of SDB with decompensated CHF (p = 0.01).

Conclusions: There is a high frequency of SDB in hospitalized patients referred for polysomnography, especially in patients with underlying cardiopulmonary disease. Further investigation of the impact of SDB on acute exacerbations of cardiopulmonary disease is needed, given the high frequency of SDB in hospitalized patients.

Figures

Figure 1

Sleep-stage percentage of inpatients versus age-matched normal control subjects. This figure shows sleep stages 1, 2, 3+4, and rapid eye movement (REM) as a percentage of total sleep time in the inpatient population studied, compared with age-matched normal controls.

Figure 2

Body mass index (BMI) versus sleep apnea. This figure shows how BMI was related to the presence of sleep disordered breathing in the inpatient population studied.