title: Prevalence of obstructive sleep apnea in patients with chronic wounds.
abstract: OBJECTIVE
  Chronic non-healing wounds are a major human and economic burden. Obstructive sleep apnea (OSA) is prevalent in patients with obesity, diabetes, aging, and cardiovascular disease, all of which are risk factors for chronic wounds. We hypothesized that OSA would have more prevalence in patients of a wound center than the general middle-aged population.
  
  
  METHODS
  Consecutive patients of the Ohio State University Comprehensive Wound Center (CWC) were surveyed with the Berlin and Epworth questionnaires. In the second stage of the protocol, 50 consecutive unselected CWC patients with lower extremity wounds underwent home sleep studies.
  
  
  RESULTS
  In 249 patients of the CWC who underwent the survey study, OSA had been previously diagnosed in only 22%. The prevalence of high-risk status based on questionnaires for OSA was 46% (95% CI 40%, 52%). In the 50 patients who underwent home sleep studies, and using an apnea hypopnea index of 15 events per hour, the prevalence of OSA was 57% (95% CI 42%, 71%). There was no difference between the Berlin questionnaire score and weight between patients with OSA and those without.
  
  
  CONCLUSIONS
  The prevalence of OSA in patients with chronic wounds exceeds the estimated prevalence of OSA in the general middle aged population. This study identifies a previously unrecognized population with high risk for OSA. Commonly used questionnaires were not sufficiently sensitive for the detection of high risk status for OSA in this patient population.
authors.affiliation: Sleep Heart Program, Critical Care, and Sleep Medicine, The Ohio State University, Columbus, OH 43210, USA.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Patt
authors.forename: David
authors.initials: D
authors.lastname: Jarjoura
authors.forename: Lynn
authors.initials: L
authors.lastname: Lambert
authors.forename: Sashwati
authors.initials: S
authors.lastname: Roy
authors.forename: Gayle
authors.initials: G
authors.lastname: Gordillo
authors.forename: Richard
authors.initials: R
authors.lastname: Schlanger
authors.forename: Chandan K
authors.initials: CK
authors.lastname: Sen
authors.forename: Rami N
authors.initials: RN
authors.lastname: Khayat
mesh_terms: D017677:Age Distribution; D002908:Chronic Disease; D015897:Comorbidity; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014945:Wound Healing; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000453:epidemiology*