Friday, January 28, 2011

Going Under: Chinese Anesthesiologists Score Low on OSA Knowledge

A new study in the journal Sleep and Breathing found that the majority of surveyed anesthesiologists lacked knowledge of obstructive sleep apnea (OSA).

Serious and life-threatening complications may occur in patients with OSA and unrecognized OSA during medical procedures.

Anesthetists should be able to identify OSA patients and feel confident in their ability to deal with a difficult airway.

The Obstructive Sleep Apnea Knowledge and Attitude Questionnaire (OSAKA) was translated into Chinese and distributed to 321 anesthesiologists from Shandong Province.

The questionnaire contained 18 knowledge items and five attitude items.

The mean total knowledge score was 11, with the scores ranging from 2 to 17. The total correct score ratio was 62 percent. Knowledge level corresponded with the participants' job titles and attitude scores. Age, sex, education, and hospital level did not affect the scores.

The survey found that when managing OSA patients, the positive attitude score was mostly below 50 percent. “Attitude” assessed the importance of the disease as a clinical disorder. It also evaluated the importance for anesthesiologists identifying OSA patients before anesthesia. Lastly, it examined the self-confidence of anesthesiologists in the management of OSA patients. With a score below 50 percent, their confidence could use a boost.

The researchers suggested that it is necessary to develop OSA training programs on OSA for Chinese anesthesiologists.

The American Society of Anesthesiologists (ASA) recommended the guidelines for difficult airway management 20 years ago, and they were revised in 2003. In addition, ASA published the guidelines for screening surgical patients with OSA preoperatively and managing OSA perioperatively in 2006.

Image by: ReSurge International

Friday, January 14, 2011

Gotta Go! Frequent Nighttime Urination May Indicate Sleep Apnea

Nocturia, which causes people to wake up during the night to urinate, has been linked to sleep apnea but is not currently used as a screening tool.

New research investigated whether nighttime urination frequency can help physician screen for this serious medical condition that causes a person to stop breathing during sleep.

The study determined the predictive power of nocturia for OSA and compared findings with other markers of OSA commonly used to screen for this disease, such as snoring.

The study was a retrospective chart review. It included 1,007 adult patients who were seeking diagnoses and treatment at one of two New Mexico sleep centers.

Patients completed detailed medical and sleep history questionnaires and took a PSG to determine their apnea–hypopnea index (AHI), which indicates OSA severity.

Some of the measurements included nocturia, snoring, body mass index (BMI), sex and age.

Snoring was reported by 77 percent and nocturia was reported by 83 percent. Eighty percent of the patient sample demonstrated OSA.

Results indicated that patient-reported nocturia predicted OSA severity more than body mass index, sex, age, and self-reported snoring.

Nocturia was very similar to snoring in regard to predictive power for clinical OSA with a comparable sensitivity of 84 percent.

Snorers had a higher mean AHI than non-snorers, and patients with nocturia had an elevated BMI.

Researchers found that nocturia appears comparable to snoring as a screening tool for OSA. Research in urology and primary care clinics is needed to clarify the use of nocturia as a screening tool.

Learn more here.

Image by Chalet Les Cîmes.

Disclaimer

The Official Blog of the American Academy of Dental Sleep Medicine (AADSM) is intended as an information source only. Content of this blog should not be used for self-diagnosis or treatment, and it is not a substitute for medical care, which should be provided by the appropriate health care professional. If you suspect you have a sleep-related breathing disorder, such as obstructive sleep apnea (OSA), you should consult your personal physician or visit an AASM-accredited sleep disorders center. The AADSM, and the American Academy of Sleep Medicine, as the managing agent of the AADSM, assume no liability for the information contained on the Official Blog of the AADSM or for its use.