title: Sleep-disordered breathing may be under-recognized in patients who wean from prolonged mechanical ventilation.
abstract: BACKGROUND
  The prevalence of sleep-disordered breathing (SDB) in patients with prolonged mechanical ventilation (PMV) is unknown. The aim of this study was to assess the frequency of SDB in patients admitted to a long-term acute care (LTAC) hospital who weaned from PMV.
  
  
  METHODS
  Retrospective  chart review was conducted of all PMV patients who had in-patient polysomnography (PSG) between January 2007 and May 2010. Main outcome measures included the frequency of SDB and tracheostomy decannulation.
  
  
  RESULTS
  Nineteen patients were studied, age 53.4 ± 13.4 years, 11 males (57.9%),  with mean body mass index of 44.0 ± 12.7 kg/m(2) (range 27.3-75.7). Eighteen patients (94.7%) demonstrated SDB as evidenced by obstructive sleep apnea (OSA), with a median respiratory disturbance index (RDI) of 24.2 events/h (range 5.9-82.0 events/h). Fourteen  patients underwent successful positive airway pressure titration, with improvement in the median RDI to 0.9 events/h (range 0.0-9.1 events/h) (P < .001). Seventeen patients (89.5%) were decannulated without adverse event.
  
  
  CONCLUSIONS
  There may be a high prevalence of unrecognized  SDB in patients who are candidates for decannulation after weaning from PMV.
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD, USA. mdiaz@medicine.umaryland.edu
authors.forename: Montserrat
authors.initials: M
authors.lastname: Diaz-Abad
authors.forename: Avelino C
authors.initials: AC
authors.lastname: Verceles
authors.forename: John E
authors.initials: JE
authors.lastname: Brown
authors.forename: Steven M
authors.initials: SM
authors.lastname: Scharf
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D007902:Length of Stay; D008134:Long-Term Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017286:Polysomnography / Q000379:methods; D011175:Positive-Pressure Respiration / Q000379:methods*; D015995:Prevalence; D012121:Respiration, Artificial / Q000379:methods*; D012124:Respiratory Care Units / Q000379:methods; D012131:Respiratory Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D015300:Ventilator Weaning / Q000009:adverse effects* / Q000379:methods