title: Risk factors for, and prevalence of, sleep apnoea in cardiac rehabilitation facilities in Germany: The Reha-Sleep registry.
abstract: OBJECTIVE
  To determine the prevalence of, and the risk factors for, sleep apnoea in cardiac rehabilitation (CR) facilities in Germany.
  
  
  METHODS
  1152 patients presenting for CR were screened for sleep-disordered breathing with 2-channel polygraphy (ApneaLink™; ResMed). Parameters recorded included the apnoea-hypopnoea index (AHI), number of desaturations per hour of recording (ODI), mean and minimum nocturnal oxygen saturation and number of snoring episodes. Patients rated subjective sleep quality on a scale from 1 (poor) to 10 (best) and completed the Epworth Sleepiness Scale (ESS).
  
  
  RESULTS
  Clinically significant sleep apnoea (AHI ≥15/h) was documented in 33% of patients. Mean AHI was 14 ± 16/h (range 0-106/h). Sleep apnoea was defined as being of moderate severity in 18% of patients (AHI ≥15-29/h) and severe in 15% (AHI ≥30/h). There were small, but statistically significant, differences in ESS score and subjective sleep quality between patients with and without sleep apnoea. Logistic regression model analysis identified the following as risk factors for sleep apnoea in CR patients: age (per 10 years) (odds ratio (OR) 1.51; p<0.001), body mass index (per 5 units) (OR 1.31; p=0.001), male gender (OR 2.19; p<0.001), type 2 diabetes mellitus (OR 1.45; p=0.040), haemoglobin level (OR 0.91; p=0.012) and witnessed apnoeas (OR 1.99; p<0.001).
  
  
  CONCLUSIONS
  The findings of this study indicate that more than one-third of patients undergoing cardiac rehabilitation in Germany have sleep apnoea, with one-third having moderate-to-severe SDB that requires further evaluation or intervention. Inclusion of sleep apnoea screening as part of cardiac rehabilitation appears to be appropriate.
authors.affiliation: Clinic for Cardiac and Pulmonary Rehabilitation, Rosenquelle, Aachen, Germany erik.skobel@rosenquelle.de.
authors.forename: Erik
authors.initials: E
authors.lastname: Skobel
authors.affiliation: MediClin Rehabilitation Centre of Spreewald, Burg/Spreewald, Germany.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Kamke
authors.affiliation: Park Klinikum, Bad Krozingen, Germany.
authors.forename: Gerd
authors.initials: G
authors.lastname: Bönner
authors.affiliation: Park-Klinik Bad Hermannsborn, Bad Driburg, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Alt
authors.affiliation: Teutoburger Wald Clinic, Rothenfelde, Germany.
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Purucker
authors.affiliation: Curschmann Clinic, Timmendorfer Strand, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schwaab
authors.affiliation: Clinic Hohenried, Department of Cardiology, Bernried, Germany.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Einwang
authors.affiliation: ZAR, Stuttgart, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Schröder
authors.affiliation: Clinic for Cardiac Rehabilitation DRV, Teltow/Seehof, Germany.
authors.forename: Eike
authors.initials: E
authors.lastname: Langheim
authors.affiliation: Clinic for Cardiac Rehabilitation Rüdersdorf, Germany Center of Rehabilitation Research University of Potsdam, Germany.
authors.forename: Heinz
authors.initials: H
authors.lastname: Völler
authors.affiliation: Clinical Trial Center Aachen, University Hospital Aachen, Aachen, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Brandenburg
authors.affiliation: ResMed Science Center, Martinsried, Munich, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Graml
authors.affiliation: ResMed Science Center, Martinsried, Munich, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Woehrle
authors.affiliation: University Hospital Aachen, RWTH, Internal Medicine I, Cardiology, Pulmonology & Vascular Medicine, Aachen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Krüger
mesh_terms: D000368:Aged; D005260:Female; D005858:Germany / Q000453:epidemiology; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017286:Polysomnography; D011237:Predictive Value of Tests; D015995:Prevalence; D012042:Registries; D012047:Rehabilitation Centers; D012119:Respiration; D012307:Risk Factors; D012720:Severity of Illness Index; D012890:Sleep; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology
keywords: Cardiac rehabilitation; sleep apnoea; sleep-disordered breathing