SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science I. Sleep Disorders – Breathing
0353
SLEEP AND BREATHING:MANAGEMENT OF SLEEP APNEA
PATIENTS IN THE PUBLIC HEALTH SYSTEM OF BRAZIL
Geovanini GR, Bezerra LM, Schorr F, Moulin S, Pessoa Junior RJ,
Pedrosa R, Genta PR, Lorenzi-Filho G
Heart Institute of University from Sao Paulo,Brazil, Sao Paulo, Brazil
Introduction: The Obstructive Sleep Apnea (OSA) is a growing public
health problem. Most patients remain undiagnosed and untreated. Polysomnography
is the gold standard for diagnosis, however inaccessible
and expensive for our population. The home polygraphy (HP) is a viable
alternative. Objective: To describe an accessible model for diagnosis and
treatment of OSA in patients from public health system of Brazil.
Methods: Patients referred to the sleep clinic of Heart Institute of University
of Sao Paulo and evaluated after the Berlin questionnaire and the
Epworth Sleepiness Scale (ESS), those with high probability of OSA
performed to home polygraphy:Stardust II. This device assesses airflow,
pulse oximetry, respiratory effort and body position. The severity of
OSA was classified according to the apnea and hypopnea index (AHI)
as mild (5-14), moderate (15-29) and severe (equal to or greater than
30 events/hour). Patients with severe OSA or moderate OSA more cardiovascular
comorbidities were referred to CPAP. That moderate OSA
without cardiovascular comorbidities were for speech therapy and mild
OSA for weight loss.
Results: Caracteristics of the sample:56 patients, 70% male, mean age
53 years, mean body mass index: 32 ± 6. 9 kg/m2. Comorbidities:current
smoker 17. 9% (n=10), COPD 12. 5% (n=7), atrial fibrillation 12. 5%
(n=7), CHF 16% (n=9), diabetes mellitus 19. 6% (n=11), CAD 19. 6%
(n=11) and hypertension 60% (n=34). Average ESS: 12 (3-23); ESS ≥10
in 57% (n=32). Obese BMI ≥30 were 55% (n=31). Snoring: 82% (n=46).
Married 67.9% (n=38). The mean AHI: 27 events/hour, with most of the
sample was moderate to severe apnea. Those who had minimum oxygen
saturation below 90% was 75% (n=42). Only 16% (n=9) had to repeat
the examination and oximetry loss represented the mainly reason for
the repetition in 88% (n=7). Unfortunately, due to financial constraints,
few patients were using CPAP. Speech therapy was a therapeutic option
for those with moderate OSA and without disease cardiovasculares. Dos
seven patients referred to speech therapy, six join treatment
Conclusion: The home polygraph is an accessible model home for the
management of obstructive sleep apnea patients in the public heathy system
of Brazil and exercises techniques of speech therapy can help treat
0354
EFFECT OF ETHNICITY AND ACCULTURATION ON
OBSTRUCTIVE SLEEP APNEA PREVALENCE AND
SEVERITY IN NON-HISPANIC WHITES AND HISPANICS
OF MEXICAN DESCENT IN SAN DIEGO COUNTY:
PRELIMINARY FINDINGS
Bercovitch R 1 , Palinkas L 3 , Ancoli-Israel S 2 , Dimsdale JE 2 , Loredo JS 1
1
Medicine, University of California, San Diego, San Diego, CA, USA,
2
Psychiatry, University of California, San Diego, San Diego, CA,
USA, 3 School of Social Work, University of Southern California, Los
Angeles, CA, USA
Introduction: We studied the prevalence and severity of obstructive
sleep apnea (OSA) in non-Hispanic whites (NHW) and Hispanics of
Mexican Descent (HMD), and examined the effect of acculturation. We
hypothesized that HMD would have a greater prevalence of OSA proportional
to degree of acculturation.
Methods: Subjects were recruited using random digit dialing as part of
the Sleep Health and Knowledge in U.S. Hispanics Study. Home polysomnography
(PSG) was performed. The Short Acculturation Scale for
Mexican Americans was used.
Results: We performed 363 PSGs (195 NHW and 168 HMD). Hispanics
of Mexican descent were heavier (BMI 29.1±7.4 vs. 27.7±5, p=0.032)
and younger (43. ±15.1 vs. 55.7±16.3 years old, p< 0.001) than NHW.
Obstructive sleep apnea (defined as AHI ≥ 5) was highly prevalent overall
(66.9%). There was no difference in average AHI between NHW
and HMD (19.8±22.5 and 20.4±24.2, p=0.79) or in the prevalence of
OSA (Men 77.6% vs. 70.4%; women 58.6% vs. 55.2%. p=0.117). There
was no difference in the prevalence of mild, moderate, or severe OSA
(defined as AHI 5 to 30 years, with matched Wisconsin Sleep Cohort participants (WSC,
n=1162) to determine if Hmong are at high risk for sleep disorders that
could contribute to SUNDS.
Methods: Three Wisconsin population-based samples of Hmong were
recruited in 1995-7 and surveyed on sleep habits and other factors. A
subsample (n=37) underwent in-home polysomnography to determine
apnea and hypopnea frequency (AHI).Multiple logistic regression was
used to estimate odds ratios (OR) for predictors of self-reported (SR)
habitual snoring and breathing pauses, both markers of sleep apnea.
Results: Prevalence of sleep apnea defined by AHI>5 was higher for
Hmong (54%) vs WSCS (32%) (p