Accuracy of clinical assessment of paediatric obstructive sleep apnoea in two English centres

2009 ◽  
Vol 123 (9) ◽  
pp. 1002-1009 ◽  
Author(s):  
E L Sproson ◽  
A M Hogan ◽  
C M Hill
Keyword(s):  
High Risk ◽  
Clinical Diagnosis ◽  
Obstructive Sleep Apnoea ◽  
Clinical Assessment ◽  
Sleep Apnoea ◽  
Diagnostic Process ◽  
Screening Guidelines ◽  
Risk Algorithm ◽  
Obstructive Sleep ◽  
The Uk

AbstractObjectives:To ascertain the sensitivity and specificity of clinical diagnosis of obstructive sleep apnoea in children, and to determine if a published clinical algorithm identifies those at high risk of post-adenotonsillectomy complications.Method:Sixty-seven children aged three to eight years underwent clinical assessment and overnight polysomnography.Results:Polysomnography detected a significant apnoea–hypopnoea index (i.e. ≥5, indicating significant obstructive sleep apnoea) in 13 (43 per cent) children with a clinical diagnosis of obstructive sleep apnoea and in six (19 per cent) children with no such diagnosis. The sensitivity of clinical assessment was 68.4 per cent and the specificity 59.5 per cent. The post-operative risk algorithm failed to identify any high risk children, although in actuality seven had severe obstructive sleep apnoea confirmed by polysomnography.Conclusions:This study of two English centres confirms that the clinical diagnostic process for obstructive sleep apnoea is reasonably insensitive and has low specificity. The studied algorithm discriminated poorly between children with and without severe obstructive sleep apnoea. Realistic diagnostic screening guidelines for paediatric sleep apnoea are overdue in the UK, where access to polysomnography is limited.

scholarly journals High Risk Characteristics for Recurrent Cardiovascular Events among Patients with Obstructive Sleep Apnoea in the SAVE Study

2018 ◽  
Vol 2-3 ◽  
pp. 59-65 ◽  
Author(s):  
Weiwei Quan ◽  
Danni Zheng ◽  
R. Douglas McEvoy ◽  
Ferran Barbe ◽  
Riu Chen ◽  
...  
Keyword(s):  
High Risk ◽  
Obstructive Sleep Apnoea ◽  
Cardiovascular Events ◽  
Sleep Apnoea ◽  
Risk Characteristics ◽  
Obstructive Sleep

scholarly journals Identifying patients at high risk for obstructive sleep apnoea syndrome in Nigeria: A multicentre observational study

2017 ◽  
Vol 29 (2) ◽  
pp. 183 ◽  
Author(s):  
Olufemi O. Desalu ◽  
Cajetan C. Onyedum ◽  
Adekunle O. Adeoti ◽  
Joseph O. Fadare ◽  
Emmanuel O. Sanya ◽  
...  
Keyword(s):  
High Risk ◽  
Observational Study ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Sleep Apnoea Syndrome ◽  
Obstructive Sleep

scholarly journals Effectiveness of a 12-week physical exercise programme on blood pressure in adults with true resistant hypertension and high risk of obstructive sleep apnoea: a study protocol for a pre-post test non randomised clinical trial

2020 ◽  
Vol 7 (2) ◽  
pp. 112
Author(s):  
Suranga Dassanayake ◽  
Gerard Wilkins ◽  
Gisela Sole ◽  
Margot Skinner
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
High Risk ◽  
Obstructive Sleep Apnoea ◽  
Resistant Hypertension ◽  
Randomised Clinical Trial ◽  
Exercise Programme ◽  
Primary Outcome Measure ◽  
Sleep Apnoea ◽  
Obstructive Sleep

<p class="abstract"><strong>Background:</strong> Resistant hypertension, a special phenotype of hypertension, is associated with increased cardiovascular risk. Exercise and physical activity are recommended as non-pharmacological interventions to manage blood pressure in hypertension. Little is known about the effectiveness of exercise in resistant hypertension. A bidirectional relationship has been identified between resistant hypertension and obstructive sleep apnoea but the literature pertaining to the benefit of exercise for populations with both conditions, is minimal. This study aims to identify the effectiveness of exercise in reducing blood pressure in a cohort of adults with resistant hypertension and high risk of obstructive sleep apnoea.</p><p class="abstract"><strong>Methods:</strong> Dunedin based adults with resistant hypertension and high risk of obstructive sleep apnoea will be recruited from the community and health centres to participate in the study. Consenting volunteers (no. of fourteen) will participate in a 12-week exercise programme including aerobic and strength training. The primary outcome measure will be 24h ambulatory blood pressure while the secondary outcomes will be anthropometrics, activity parameters, sleep parameters, cardiac structure and function, and quality of life. The measurements at the end of the 12-week exercise programme will be compared with baseline to determine the effectiveness of exercise in reducing blood pressure in the cohort with resistant hypertension and risk of obstructive sleep apnoea.</p><p class="abstract"><strong>Conclusions: </strong>Exercise and physical activity are recommended to manage hypertension. Therefore, it is anticipated that the exercise programme will have a positive effect on the blood pressure of the participants. The findings have potential to change the direction of research in the area by filling the knowledge gaps.</p><p class="abstract"><strong>Trial Registration:</strong> The Ministry of Health, New Zealand (Ethics Ref: 18/CEN/257), Trial registry: ACTRN12618001881224p).</p>

scholarly journals O021 Preferred attributes of care pathways for obstructive sleep apnoea from the perspective of diagnosed patients and high-risk individuals: a discrete choice experiment

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A10-A10
Author(s):  
A Natsky ◽  
A Vakulin ◽  
C Chai Coetzer ◽  
R Adams ◽  
R McEvoy ◽  
...  
Keyword(s):  
High Risk ◽  
Discrete Choice ◽  
Obstructive Sleep Apnoea ◽  
Choice Experiment ◽  
Sleep Apnoea ◽  
Care Pathways ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Ongoing Care

Abstract Background The current health care system is challenged with a large and rising demand for obstructive sleep apnoea (OSA) services. A paradigm shift in OSA management is required to incorporate the preferences of diagnosed patients and individuals at high-risk of OSA. This study aimed to provide empirical evidence of the values and preferences of individuals diagnosed with OSA and high-risk populations regarding distinct OSA care pathway features. Methods A discrete choice experiment (DCE) was undertaken in two groups: those with a formal diagnosis of OSA (n=421) and those undiagnosed but at high-risk of having OSA (n=1033). The DCE approach used mixed logit regression models to determine preferences relating to eight salient features of OSA management pathway, i.e. initial assessment, setting and diagnosis costs, waiting times, results interpretation, treatment options, provider of ongoing care and frequency of follow up visits. Results The findings indicate that all eight attributes investigated were statistically significant factors for respondents. Generally, both groups preferred low diagnostic costs, fewer follow-up visits, minimum waiting time for sleep study results, and sleep specialists to recommend treatment and as ongoing care providers. Management of OSA in primary care was acceptable to both groups and was the most preferred option by the high-risk group for sleep study testing and ongoing care provision. Discussion The DCE results offer a promising approach for systematic incorporation of patient and high-risk groups preferences into the future design and delivery of care pathways for OSA management.

scholarly journals Prevalence of high risk obstructive sleep apnoea by Berlin questionnaire in patients with hypertension: study from a tertiary care hospital

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Ozaifa Kareem ◽  
Masood Tanvir ◽  
G. N. Bader
Keyword(s):  
High Risk ◽  
Obstructive Sleep Apnoea ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sleep Apnoea ◽  
Berlin Questionnaire ◽  
Care Hospital ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
The Mean

Abstract Background Obstructive Sleep Apnoea (OSA), a condition characterized by a complete or partial cessation of airflow during sleep, can cause various cardiovascular disorders including hypertension. The aim of the study was to determine the prevalence of OSA in patients with hypertension. Methods A cross-sectional prospective cohort study of 504 patients with hypertension was undertaken at a tertiary care hospital of India for a period of 6 months. OSA was evaluated using the Berlin questionnaire while the daytime sleepiness was determined using Epworth Sleepiness Scale. Data analysis was done using SPSS v. 20. Results High risk of OSA was identified in 120 (23.8%) patients and the prevalence of sleepiness (Epworth Sleepiness score >16) was found to be 32.5% (95% CI, p < 0.001) in these patients. The mean neck circumference, waist circumference and waist-to-hip ratio for high-risk OSA group were 37.41 ± 3.396 cm, 105.90 ± 11.28 cm and 1.01 ± 0.065 respectively while for the low-risk group, these parameters were 35.45 ± 2.652 cm, 98.75 ± 10.87 cm and 0.99 ± 0.080 respectively (95% CI, p<0.001). The mean blood pressure (BP) ≥133.52/84.37 mmHg was recorded in patients with a high risk of OSA (95% CI, P < 0.05), and resistant hypertension (3.3%) was significantly associated with the risk of OSA (95% CI, P < 0.05). Conclusion In the tertiary health care setting, the prevalence of high-risk of OSA in patients with hypertension is high. Screening for OSA should be a part of the hypertensive medical investigation and patients may benefit from a proper evaluation of OSA.

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