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Sleep-disordered breathing in fatigued postpoliomyelitis clinic patients.

Dahan V, Kimoff RJ, Petrof BJ, Benedetti A, Diorio D, Trojan DA

Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.

OBJECTIVE: To determine the frequency, predictive factors, and symptoms predictive of sleep-disordered breathing (SDB) in fatigued postpoliomyelitis clinic patients. DESIGN: Cross-sectional, retrospective chart review. SETTING: University-affiliated hospital postpolio clinic. PARTICIPANTS: Postpolio clinic charts (N=590) were reviewed. Ninety-eight patients were included, and 492 patients were not included, primarily because of the lack of a polysomnogram. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The Apnea-Hypopnea Index (AHI) calculated as the total number of sleep-related breathing events/total sleep time. RESULTS: The frequency of SDB defined by an AHI score of 5 or more was 65% and by an AHI score of 10 or more was 50%. Obstructive hypopnea was the predominant form, occurring in 86%. Age, sex, age at acute polio, time since polio, weakness and respiratory difficulties at acute polio, bulbar involvement at acute polio and at evaluation, body mass index, pulmonary function measures, alcohol use, sedative drug use, smoking, fibromyalgia, kyphoscoliosis, and scoliosis and ear-nose-throat surgery were not predictive of SDB (AHI scores > or =5 and > or =10). Snoring was more common in subjects with SDB (AHI score > or =5 and > or =10). Some pulmonary function measures correlated with oxygen saturation during sleep in SDB (AHI scores > or =5). CONCLUSIONS: SDB was very common in fatigued postpoliomyelitis clinic patients referred for sleep evaluation. Obstructive hypopnea was the most frequent type. In this preliminary study, snoring tended to predict SDB.

Published 6 October 2006 in Arch Phys Med Rehabil, 87(10): 1352-6.
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