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JCSM: A high frequency of sleep-related breathing disorders in hospitalized patients

WESTCHESTER, Ill. There is a high frequency of sleep-related breathing disorders (SRBD) in hospitalized patients referred for polysomnography (PSG), also known as an overnight sleep test, especially in patients with underlying cardiopulmonary disease, according to a study published in the April 15 issue of the Journal of Clinical Sleep Medicine (JCSM).

The study, authored by Kim Goring, MD, of Johns Hopkins University and Bayview Medical Center in Baltimore, Md., was a retrospective chart review of 100 PSGs and medical records of all patients who had PSG while hospitalized at two tertiary care centers between January 2003 and September 2004. The main outcome measures included the frequency of and the association between an SRBD and specific characteristics, including age, sex, body mass index (BMI), and admission disease condition.

According to the results, 77 percent of the sample had an SRBD. There was an increase in the odds ratio of SRBD with increasing BMI. Increasing BMI categories were associated with more severe SRBD. Adjusting for age and BMI, men had a reduced odds ratio of sleep apnea, as compared to women, and women with SRBD were more likely to have more severe disease than men. There was a significant association of SRBD with congestive heart failure.

This study points out the importance of considering sleep apnea in hospitalized patients. It shows that it is common in that population and may impact upon the treatments and outcome during their stay, said Nancy A. Collop, MD, of Johns Hopkins University, corresponding author of the study. Further research on how sleep apnea impacts the acutely ill patient is needed.

Obstructive sleep apnea (OSA) is an SRBD that causes your body to stop breathing during sleep. OSA occurs when the tissue in the back of the throat collapses and blocks the airway. This keeps air from getting into the lungs. It is estimated that four percent of men and two percent of women have OSA, and millions more remain undiagnosed.

On average, most adults need seven to eight hours of nightly sleep to feel alert and well-rested.

The American Academy of Sleep Medicine (AASM) offers the following tips on how to get a good nights sleep:

  • Follow a consistent bedtime routine.

  • Establish a relaxing setting at bedtime.

  • Get a full nights sleep every night.

  • Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.

  • Do not bring your worries to bed with you.

  • Do not go to bed hungry, but dont eat a big meal before bedtime either.

  • Avoid any rigorous exercise within six hours of your bedtime.

  • Make your bedroom quiet, dark and a little bit cool.

  • Get up at the same time every morning.

First introduced as a treatment option for sleep apnea in 1981, CPAP is the most common and effective treatment for OSA. CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize sleep apnea and restoring normal oxygen levels.


Contact: Jim Arcuri
American Academy of Sleep Medicine

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