Simple screening model for identifying the risk of sleep apnea in patients on opioids for chronic pain: an infographic

BackgroundThere is an increased risk of sleep apnea in patients using opioids for chronic pain. We hypothesized that a simple model comprizing of: (1) STOP-Bang questionnaire and resting daytime oxyhemoglobin saturation (SpO2); and (2) overnight oximetry will identify those at risk of moderate-to-severe sleep apnea in patients with chronic pain.MethodAdults on opioids for chronic pain were recruited from pain clinics. Participants completed the STOP-Bang questionnaire, resting daytime SpO2, and in-laboratory polysomnography. Overnight oximetry was performed at home to derive the Oxygen Desaturation Index. A STOP-Bang score ≥3 or resting daytime SpO2 ≤95% were used as thresholds for the first step, and for those identified at risk, overnight oximetry was used for further screening. The Oxygen Desaturation Index from overnight oximetry was validated against the Apnea-Hypopnea Index (≥15 events/hour) from polysomnography.ResultsOf 199 participants (52.5±12.8 years, 58% women), 159 (79.9%) had a STOP-Bang score ≥3 or resting SpO2 ≤95% and entered the second step (overnight oximetry). Using an Oxygen Desaturation Index ≥5 events/hour, the model had a sensitivity of 86.4% and specificity of 52% for identifying moderate-to-severe sleep apnea. The number of participants who would require diagnostic sleep studies was decreased by 38% from Step 1 to Step 2 of the model.ConclusionA simple model using STOP-Bang questionnaire and resting daytime SpO2, followed by overnight oximetry, can identify those at high risk of moderate-to-severe sleep apnea in patients using opioids for chronic pain.Trial registration numberNCT02513836.

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Simulink-based sleep apnea screening model for portable diagnosis

2009 International Conference on Intelligent Sensors, Sensor Networks and Information Processing (ISSNIP) ◽

10.1109/issnip.2009.5416803 ◽

2009 ◽

Author(s):

Kian H. Ang ◽

Yuanda Xu ◽

Ahsan H. Khandoker

Keyword(s):

Sleep Apnea ◽

Screening Model

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Concomitant benzodiazepine use with opioids decreases the risk of sleep apnea in chronic pain patients on opioid therapy

Sleep Medicine ◽

10.1016/j.sleep.2019.11.723 ◽

2019 ◽

Vol 64 ◽

pp. S258-S259

Author(s):

S. Mir ◽

J. Wong ◽

C. Ryan ◽

R. Waseem ◽

C. Suen ◽

...

Keyword(s):

Chronic Pain ◽

Sleep Apnea ◽

Opioid Therapy ◽

Chronic Pain Patients ◽

Benzodiazepine Use ◽

Pain Patients

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The NoSAS score: A new and simple screening tool for obstructive sleep apnea syndrome in depressive disorder

Journal of Affective Disorders ◽

10.1016/j.jad.2017.10.015 ◽

2018 ◽

Vol 227 ◽

pp. 136-140 ◽

Cited By ~ 8

Author(s):

Kelly Guichard ◽

Helena Marti-Soler ◽

Jean-Arthur Micoulaud-Franchi ◽

Pierre Philip ◽

Pedro Marques-Vidal ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Depressive Disorder ◽

Obstructive Sleep Apnea Syndrome ◽

Screening Tool ◽

Sleep Apnea Syndrome ◽

Obstructive Sleep ◽

Apnea Syndrome ◽

Simple Screening

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Obstructive sleep apnea and chronic pain as risk factors of cognitive impairment in elderly population: A study from Indonesia

Narra J ◽

10.52225/narra.v1i3.62 ◽

2021 ◽

Vol 1 (3) ◽

Author(s):

Tiara Tiara ◽

Fidiana Fidiana

Keyword(s):

Chronic Pain ◽

Obstructive Sleep Apnea ◽

Logistic Regression ◽

Cognitive Impairment ◽

Sleep Apnea ◽

Cognitive Function ◽

High Risk ◽

Multivariate Logistic Regression Analysis ◽

The Elderly ◽

Obstructive Sleep

Obstructive sleep apnea (OSA), one of the most prevalent sleep-related breathing disorders in the elderly, seems to be underdiagnosed. Meanwhile, the resulting complication on cognitive function could impact on patient’s quality of life. Association between OSA and cognitive function in the elderly varies highly, depending on study type, setting, and possibly by demographic differences. Therefore, this study sought to determine the risk of OSA among elderly and to assess the association of OSA risk and other plausible factors with cognitive function. In this cross-sectional study, patients aged 60 years and above who visited the outpatient clinic at two main hospitals in Surabaya of Indonesia were examined. A total of 178 participants were interviewed to evaluate the OSA risk using STOP-Bang questionnaire, the cognitive dysfunction using Montreal Cognitive Assessment Indonesian version (MoCA-Ina), depressive symptoms using Geriatric Depression Scale-15 (GDS-15), and sleep disorder using Insomnia Screening Questionnaire (ISQ). The Mann-Whitney and Chi-square tests were used to assess factors associated with cognitive impairment. In addition, logistic regression analyses were performed to evaluate the role of high risk of OSA on cognitive impairment. A total of 120 patients were considered having high risk of OSA (STOP-Bang score ≥3), and 129 had mild cognitive impairment (MCI) (MoCA-Ina <26). Among the elderly who had high risk of OSA, 94 were diagnosed with MCI (78.3%). Multivariate logistic regression analysis showed that high risk of OSA (OR: 2.99; 95%CI: 1.39, 6.46, p=0.005), chronic pain (OR: 5.53; 95%CI: 1.19, 25.64, p=0.029), and low education level (OR: 4.57; 95%CI: 1.79, 11.63) were associated with MCI. In conclusion, our data suggests a high prevalence of MCI among high risk OSA elderly. Screening and comprehensive management might be beneficial to improve or to preserve cognitive function in elderly group.

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IDDF2021-ABS-0203 A screening model for obstructive sleep apnea on the basis of fatty liver disease-related parameters

10.1136/gutjnl-2021-iddf.103 ◽

2021 ◽

Author(s):

Yang-Bor Lu ◽

Yu-Chieh Weng ◽

Yung-Ning Huang ◽

Hsiung-Ying Huang ◽

Pei-Ting Cheng ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Liver Disease ◽

Sleep Apnea ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Screening Model ◽

Obstructive Sleep

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Pain and Addiction in Patients with Co-Occurring Medical Disorders (DRAFT)

10.1093/med/9780190265366.003.0026 ◽

2018 ◽

Author(s):

Stephen Colameco

Keyword(s):

Chronic Pain ◽

Neuropathic Pain ◽

Low Back Pain ◽

Chronic Pancreatitis ◽

Sleep Apnea ◽

Hiv Infection ◽

Low Back ◽

Gastric Hemorrhage ◽

Medical Disorders ◽

Altered Metabolism

Distinct from Chapter 24, on co-occurring psychiatric disorders, this chapter addresses common physical comorbidities that give rise to chronic pain and are notorious for associated substance use disorders. The concept of “pseudo-addiction” is explored as one of several contributors to common misperceptions of the analgesic needs of such patients. Examples of entities discussed are chronic low back pain, sleep apnea, chronic pancreatitis, cirrhosis, and HIV infection or AIDS-related pain. While not intrinsically painful, sleep apnea merits inclusion as it arises in conjunction with sedative-hypnotic, opioid, or nicotine use. Cirrhosis likewise creates obstacles to successful pain or addiction management resulting from altered metabolism of medications and enhanced susceptibility to potentially lethal syndromes (hepato-renal syndrome, gastric hemorrhage, etc.). The management of neuropathic pain in HIV infection (Chapter 15) is amplified here.

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