title: Incidence, Characterization, and Predictors of Sleep Apnea in Consecutive Brain Injury Rehabilitation Admissions.
abstract: OBJECTIVE
  To prospectively examine the incidence and risk factors for sleep apnea in consecutive brain injury rehabilitation admissions.
  
  
  METHODS
  Inpatient neurorehabilitation hospital.
  
  
  METHODS
  Participants (n = 86) were consecutive neurorehabilitation admissions.
  
  
  METHODS
  Retrospective analysis of prospectively collected data.
  
  
  METHODS
  Polysomnography.
  
  
  RESULTS
  Half (49%) of the sample was diagnosed with sleep apnea. For the full sample, univariate logistic regression revealed age (odds ratio: 1.08; 95% confidence interval: 1.04-1.11) and hypertension (odds ratio: 7.77; 95% confidence interval: 2.81-21.47) as significant predictors of sleep apnea diagnosis. Results of logistic regression conducted within the traumatic brain injury group revealed age (odds ratio: 1.07; 95% confidence interval: 1.02-1.13) as the only significant predictor of apnea diagnosis after adjustment for other variables. Hierarchical generalized linear regression models for the prediction of apnea severity (ie, apnea-hypopnea index found that Functional Independence Measure Cognition Score (P = .01) and age (P < .01) were significant predictors. Following adjustment for all other terms, only age (P < .01) remained significant.
  
  
  CONCLUSIONS
  Sleep apnea is prevalent in acute neurorehabilitation admissions and traditional risk profiles for sleep apnea may not effectively screen for the disorder. Given the progressive nature of obstructive sleep apnea and morbidity associated with even mild obstructive sleep apnea, early identification and intervention may address comorbidities influencing acute and long-term outcome.
authors.affiliation: Departments of MHBS (Drs Holcomb and Nakase-Richardson), Medicine (Dr Schwartz), and Rehabilitation Medicine (Drs McCarthy, Thomas), James A. Haley Veterans' Hospital, Tampa, Florida; Departments of Medicine (Drs Schwartz and Nakase-Richardson) and Neurology (Drs McCarthy and Thomas), University of South Florida, Tampa; and Department of Research (Dr Barnett), Center of Innovation in Disability Rehabilitation and Research (CINDRR) (Dr Nakase-Richardson), and Defense and Veterans Brain Injury Center (DVBIC) (Dr Nakase-Richardson), James A. Haley Veterans' Hospital, Tampa, Florida.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Holcomb
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Schwartz
authors.forename: Marissa
authors.initials: M
authors.lastname: McCarthy
authors.forename: Bryan
authors.initials: B
authors.lastname: Thomas
authors.forename: Scott D
authors.initials: SD
authors.lastname: Barnett
authors.forename: Risa
authors.initials: R
authors.lastname: Nakase-Richardson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000534:rehabilitation*; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012189:Retrospective Studies; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult