Abstract
Objective: To evaluated the results of the STOP and Insomnia Severity Index (ISI) and report the prevalence of high risk OSA (HR-OSA) and significant insomnia
Background: Obstructive sleep apnea (OAS) and insomnia are highly prevalent, however limited data exist using sleep screening instruments in neurological populations.
Design/Methods: STOP and ISI were collected from March 2015–October 2016 at the first outpatient visit in Adult Psychiatry (AP), Movement Disorders (MD), Cerebrovascular (CV), Brain Tumor (BT) and Epilepsy (EP) Center in the Cleveland Clinic Neurological Institute. HR-OSA was defined as STOP ≥2 and significant insomnia as ISI ≥15. The association between HR-OSA/significant insomnia and disease-specific outcomes including modified Rankin scale (CV), Unified Parkinson Disease Rating scale (UPDRS) II (MD), Eastern Cooperative Oncology Group (ECOG) Performance and Karnofsky Performance Status (KPS) scales (BT), Liverpool Seizure Severity scale (LSSS) (EP), and Patient Health Questionnaire-9 (AP) was examined using multivariate logistic regression models
Results: 9159 patients were included with 7979 completing STOP and 8799 completing ISI. Crude prevalence for HR-OSA and significant insomnia were higher in CV and AP [47.89 (45.18–50.62), 33.64 (31.86–35.46) respectively]. Multivariate logistic regression comparing centers adjusted for covariates including PHQ-9 as reference showed difference in ISI score with higher odds of insomnia (OR 1.584;1.25–2.007) in BT and difference in STOP score with higher odds of HR-OSA in BT, CV and EP (OR1.427;1.165–1.748, OR 1.912;1.591–2.297, OR1.48;1.255–1.746, respectively). Individual models showed a significant association between PHQ-9 and HR-OSA and insomnia (p<0.001, p<0.001) and between UPDRS-II and insomnia (p=0.001).
Conclusions: HR-OSA and significant insomnia are highly prevalent in neurological patients. More abnormal STOP and ISI scores were associated with worse disease-specific outcomes. Routine screening of common, treatable sleep disorders in neurological populations is recommended.
Study Supported by:
Cleveland Clinic Knowledge Program Data Registry and Neurological Institute Center for Outcomes Research and Evaluation
Disclosure: Dr. Somboon has nothing to disclose. Dr. Walia has nothing to disclose. Dr. Kinzy has nothing to disclose. Dr. Katzan has nothing to disclose. Dr. Foldvary-Schaefer has nothing to disclose.
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