The Significance of the Screening for Sleep Apnea Syndrome in Human Dry Dock
Objective: In recent years, in the health management of middle-aged and older males, recognition of sleep apnea syndrome (SAS) is being increasingly emphasized. Methods: We performed a screening for SAS using pulse oximetry in our human dry dock. The subjects were 1,196 adults. After filling out the...
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| Published in | Official Journal of the Japanese Society of Human Dry Dock Vol. 19; no. 4; pp. 580 - 585 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
JAPAN SOCIETY OF NINGEN DOCK
20.12.2004
公益社団法人 日本人間ドック学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0914-0328 2186-5019 |
| DOI | 10.11320/ningendock1986.19.580 |
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| Abstract | Objective: In recent years, in the health management of middle-aged and older males, recognition of sleep apnea syndrome (SAS) is being increasingly emphasized. Methods: We performed a screening for SAS using pulse oximetry in our human dry dock. The subjects were 1,196 adults. After filling out the questionnaire about sleep disorder and epworth sleepiness scale (ESS) score, pulse oximetry was performed on all subjects during sleep for one night to determine the oxygen desaturation index (ODI) 3%. Those strongly suspected of SAS from the questionnaire results and also those with the ODI 3%≥10 were interpreted as suspected SAS subjects; and they were then subjected to polysomnography (PSG) as candidates for the secondary screening for SAS. Those with the ODI 3% ≥10were 209 subjects. Results: The body mass index (BMI), habitual snoring, observed sleep apnea were independent factors for ODI 3%, and BMI yielded the highest correlation coefficient. About 85% of the subjects who had PSG were diagnosed with sleep disordered breathing (apnea hyponea index (AHI) ≥10). There was a significant correlation between PSG-AHI and ODI 3% but the ESS score was not correlated with PSG-AHI. The 53 subjects were AHI ≥30 and required medical treatment. Conclusions: Our results indicate that pulse oximetry analysis can be a valuable tool as the initial screening for SAS in human dry dock. |
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| AbstractList | Objective: In recent years, in the health management of middle-aged and older males, recognition of sleep apnea syndrome (SAS) is being increasingly emphasized. Methods: We performed a screening for SAS using pulse oximetry in our human dry dock. The subjects were 1,196 adults. After filling out the questionnaire about sleep disorder and epworth sleepiness scale (ESS) score, pulse oximetry was performed on all subjects during sleep for one night to determine the oxygen desaturation index (ODI) 3%. Those strongly suspected of SAS from the questionnaire results and also those with the ODI 3%≥10 were interpreted as suspected SAS subjects; and they were then subjected to polysomnography (PSG) as candidates for the secondary screening for SAS. Those with the ODI 3% ≥10were 209 subjects. Results: The body mass index (BMI), habitual snoring, observed sleep apnea were independent factors for ODI 3%, and BMI yielded the highest correlation coefficient. About 85% of the subjects who had PSG were diagnosed with sleep disordered breathing (apnea hyponea index (AHI) ≥10). There was a significant correlation between PSG-AHI and ODI 3% but the ESS score was not correlated with PSG-AHI. The 53 subjects were AHI ≥30 and required medical treatment. Conclusions: Our results indicate that pulse oximetry analysis can be a valuable tool as the initial screening for SAS in human dry dock.
目的:近年,中高年男性の健康管理において,睡眠時無呼吸症候群(sleep apnea syndrome:SAS)の重要性が認識され,SASスクリーニング検査が健診にて導入されてきている.SASのスクリーニング検査には過眠症状の指標となるESS(epworth sleep iness scale)など問診が最初に行われるが,この場合検者自身の主観に依存する傾向がある.そこで,今回我々は,このような問診に,睡眠中のパルスオキシメーター検査を加えて,SASスクリーニング検査を試みた.方法:対象は,当院にて一泊二日人間ドックを受検した1,496名で,全員にESSスコアを含む睡眠に関する問診を行い,宿泊施設あるいは自宅にて携帯型パルスオキシメーターで睡眠中の動脈血酸素飽和度を測定した.問診からSASが強く疑われる者,ESSスコア高値であった者および酸素飽和度低下指数(oxygen desaturation index:ODI)3%が10以上となった者をSAS疑いの二次検査対象者とし,簡易睡眠モニター検査,もしくはポリソムノグラフィー(polysomnography:PSG)検査を施行した.結果:ODI3%値が10以上は全体の17%の209名で女性は16名のみだった.ODI3%値を規定するパラメーターはBMI(body mass index),いびき,無呼吸の指摘などで,特にBMIとは強い相関を認めた.さらに,二次検査受検者の約85%が無呼吸低呼吸指数(apnea hyponea index:AHI)10以上の睡眠呼吸障害(sleepdisordered breathing:SDB)と診断され,AHI30以上で加療が不可欠と思われた者は53名にのぼっ た.PSG検査のAHIは,パルスオキシメーター検査のODI3%と強い相関を認めたが,ESSスコアとは全く相関を認めなかった.結論:今回の結果より,SAS,SDBをスクリーニングするには問診,ESSスコアなど自覚症状のみでは限界があり,人間ドックでのスクリーニング検査としてはパルスオキシメーター検査も併用するのが有用であると考えられた. Objective: In recent years, in the health management of middle-aged and older males, recognition of sleep apnea syndrome (SAS) is being increasingly emphasized. Methods: We performed a screening for SAS using pulse oximetry in our human dry dock. The subjects were 1,196 adults. After filling out the questionnaire about sleep disorder and epworth sleepiness scale (ESS) score, pulse oximetry was performed on all subjects during sleep for one night to determine the oxygen desaturation index (ODI) 3%. Those strongly suspected of SAS from the questionnaire results and also those with the ODI 3%≥10 were interpreted as suspected SAS subjects; and they were then subjected to polysomnography (PSG) as candidates for the secondary screening for SAS. Those with the ODI 3% ≥10were 209 subjects. Results: The body mass index (BMI), habitual snoring, observed sleep apnea were independent factors for ODI 3%, and BMI yielded the highest correlation coefficient. About 85% of the subjects who had PSG were diagnosed with sleep disordered breathing (apnea hyponea index (AHI) ≥10). There was a significant correlation between PSG-AHI and ODI 3% but the ESS score was not correlated with PSG-AHI. The 53 subjects were AHI ≥30 and required medical treatment. Conclusions: Our results indicate that pulse oximetry analysis can be a valuable tool as the initial screening for SAS in human dry dock. |
| Author | Momoi, Atsuko Yoshitaka, Sumie Fukui, Toshiki Yasuda, Tadashi |
| Author_FL | 福井 敏樹 安田 忠司 吉鷹 寿美江 桃井 篤子 |
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| References | 10) Ryan PJ, Hilton MF, et al: Validation of British Thoracic Society Guidelines for the diagnosis of the sleep apnoea/hypopnoea syndrome: Can polysomnography be avoided? Thorax 50: 972-975, 1995. 7) Wiltshire N, Kendrick AH, et al: Home oximetry studies for diagnosis of sleep apnea/hypopnea syndrome: limitation of memory storage capabilities. Chest 120: 384-389, 2001. 8) Gyulay S, Olson LG, et al: A comparison of clinical assessment and home oximetry in the diagnosis of obstructive sleep apnea. Am Rev Respir Dis 147: 50-53, 1993. 1) Peppard PE, Young T, et al: Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342: 1378-1384, 2000. 4)宮脇尚志, 宮山真弓ほか: 人間ドックにおける携帯型パルスオキシメーターを用いた睡眠時無呼吸症候群スクリーニング. 総合健診 30: 34-37, 2003. 9) Chiner E, Signes-Costa J, et al: Nocturnal oximetry for the diagnosis of the sleep apnoea hypopnoea syndrome: a method to reduce the number of polysomnographies? Thorax 54: 968-971, 1999. 11) Hida W, Shindoh C, et al: Prevalence of sleep apnea among Japanese industrial workers determined by a portable sleep monitoring system. Respiration 60: 332-337, 1993. 3) Young T, Palta M, et al: The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328: 1230-1235, 1993. 5) Ip MS, Lam B, et al: Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med 165: 670-676, 2002. 2) Shahar E, Whitney CW, et al: Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med 163: 19-25, 2001. 6) Bloch KE: Getting the most out of nocturnal pulse oximetry. Chest 124: 1628-1630, 2003. |
| References_xml | – reference: 9) Chiner E, Signes-Costa J, et al: Nocturnal oximetry for the diagnosis of the sleep apnoea hypopnoea syndrome: a method to reduce the number of polysomnographies? Thorax 54: 968-971, 1999. – reference: 4)宮脇尚志, 宮山真弓ほか: 人間ドックにおける携帯型パルスオキシメーターを用いた睡眠時無呼吸症候群スクリーニング. 総合健診 30: 34-37, 2003. – reference: 6) Bloch KE: Getting the most out of nocturnal pulse oximetry. Chest 124: 1628-1630, 2003. – reference: 2) Shahar E, Whitney CW, et al: Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med 163: 19-25, 2001. – reference: 1) Peppard PE, Young T, et al: Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342: 1378-1384, 2000. – reference: 7) Wiltshire N, Kendrick AH, et al: Home oximetry studies for diagnosis of sleep apnea/hypopnea syndrome: limitation of memory storage capabilities. Chest 120: 384-389, 2001. – reference: 10) Ryan PJ, Hilton MF, et al: Validation of British Thoracic Society Guidelines for the diagnosis of the sleep apnoea/hypopnoea syndrome: Can polysomnography be avoided? Thorax 50: 972-975, 1995. – reference: 11) Hida W, Shindoh C, et al: Prevalence of sleep apnea among Japanese industrial workers determined by a portable sleep monitoring system. Respiration 60: 332-337, 1993. – reference: 5) Ip MS, Lam B, et al: Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med 165: 670-676, 2002. – reference: 3) Young T, Palta M, et al: The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328: 1230-1235, 1993. – reference: 8) Gyulay S, Olson LG, et al: A comparison of clinical assessment and home oximetry in the diagnosis of obstructive sleep apnea. Am Rev Respir Dis 147: 50-53, 1993. |
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| SubjectTerms | epworth sleepiness scale (ESS) ESSスコア ODI3 oxygen desaturation index (ODI) 3 pulse oximetry sleep apnea syndrome (SAS) パルスオキシメーター 睡眠時無呼吸症候群 |
| Title | The Significance of the Screening for Sleep Apnea Syndrome in Human Dry Dock |
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