title: Risk of sleep apnea in hospitalized older patients.
abstract: OBJECTIVE
  To assess the prevalence of undiagnosed obstructive sleep apnea (OSA) among general medical inpatients and to investigate whether OSA risk is associated with in-hospital sleep quantity and quality.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  General medicine ward in academic medical center.
  
  
  METHODS
  424 hospitalized adult patients ≥ 50 years old without a sleep disorder diagnosis (mean age 65 years, 57% female, 72% African American).
  
  
  METHODS
  The Berlin questionnaire, a validated screen for determining risk of OSA, was administered to hospitalized medical patients. Sleep duration and efficiency were measured via wrist actigraphy. Self-reported sleep quality was evaluated using Karolinska Sleep Quality Index (KSQI).
  
  
  RESULTS
  Two of every 5 inpatients ≥ 50 years old (39.5%, n = 168) were found to be at high risk for OSA. Mean in-hospital sleep duration was ∼ 5 h and mean sleep efficiency was 70%. Using random effects linear regression models, we found that patients who screened at high risk for OSA obtained ∼ 40 min less sleep per night (-39.6 min [-66.5, -12.8], p = 0.004). These findings remained significant after controlling for African American race, sex, and age quartiles. In similar models, those patients who screened at high risk had ∼ 5.5% less sleep efficiency per night (-5.50 [-9.96, -1.05], p = 0.015). In multivariate analysis, patients at high risk for OSA also had lower self-reported sleep quality on KSQI (-0.101 [-0.164, -0.037], p = 0.002).
  
  
  CONCLUSIONS
  Two of every 5 inpatients older than 50 years screened at high risk for OSA. Those screening at high risk have worse in-hospital sleep quantity and quality.
  
  
  CONCLUSIONS
  A commentary on this article appears in this issue on page 1067.
authors.affiliation: Pritzker School of Medicine, University of Chicago, Chicago, IL.
authors.forename: Talia C
authors.initials: TC
authors.lastname: Shear
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL ; Sleep, Metabolism and Health Center, University of Chicago, Chicago, IL.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Balachandran
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL ; Sleep, Metabolism and Health Center, University of Chicago, Chicago, IL.
authors.forename: Babak
authors.initials: B
authors.lastname: Mokhlesi
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Spampinato
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL ; Sleep, Metabolism and Health Center, University of Chicago, Chicago, IL.
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Knutson
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL.
authors.forename: David O
authors.initials: DO
authors.lastname: Meltzer
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL ; Sleep, Metabolism and Health Center, University of Chicago, Chicago, IL.
authors.forename: Vineet M
authors.initials: VM
authors.lastname: Arora
mesh_terms: D000368:Aged; D002641:Chicago / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017286:Polysomnography / Q000379:methods; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: hospitalized patients; obstructive sleep apnea; sleep