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      Polysomnography vs self-reported measures in patients with sleep apnea.

      Archives of otolaryngology--head & neck surgery
      Adolescent, Adult, Aged, Aged, 80 and over, Attitude to Health, Comorbidity, Cost of Illness, Cross-Sectional Studies, Disorders of Excessive Somnolence, diagnosis, epidemiology, psychology, Female, Health Status, Humans, Male, Middle Aged, Polysomnography, Retrospective Studies, Sleep Apnea, Obstructive, Statistics as Topic, Washington

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          Abstract

          While obstructive sleep apnea syndrome is defined by both polysomnographic (PSG) abnormalities and symptoms, severity is quantified primarily by the apnea-hypopnea index (AHI) alone. To determine the correlation between standard PSG indices (AHI and others) and self-reported sleepiness, mental health status, and general health in patients with sleep apnea. Cross-sectional study. University-affiliated outpatient sleep laboratory. Ninety-six consecutive patients with PSG-confirmed sleep apnea (AHI >or=5). Patients completed a questionnaire that included the Epworth Sleepiness Scale, Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) mental health domain, and self-rated health on the evening of diagnostic PSG. Spearman correlation coefficients were computed. This sample had 85% power to detect a correlation of 0.3 or greater. The associations between PSG indices and self-reported measures were further assessed with multivariable regression techniques, adjusting for age, sex, body mass index, comorbidity, and PSG type. The PSG parameters correlated poorly with self-reported measures (15 correlations; range of magnitude, 0.004-0.24; mean, 0.09). AHI was not associated with self-reported sleepiness or general health, and it was associated with the SF-36 Health Status mental health domain only on multiple linear regression (P =.04) but not on multiple logistic regression (adjusted odds ratio, 1.02; 95% confidence interval, 1.00-1.04; P =.09). In general, PSG measures, and AHI in particular, correlated poorly with self-reported measures in a clinical sleep laboratory sample. After adjustment for potentially confounding variables, weak associations were found between some PSG indices and selected self-reported measures. These findings suggest that sleep apnea disease burden should be quantified with both physiologic and subjective measures.

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