Observation-based nocturnal sleep inventory: screening tool for sleep apnea in elderly people

J Am Geriatr Soc. 2008 Oct;56(10):1920-5. doi: 10.1111/j.1532-5415.2008.01862.x. Epub 2008 Sep 4.

Abstract

Objectives: To measure the ability of the Observation-based Nocturnal Sleep Inventory (ONSI) to detect the presence or absence of sleep apnea syndrome (SAS) in older adults.

Design: Cross-sectional blinded study.

Setting: University hospital-based geriatric sleep center.

Participants: All participants aged 70 and older were referred by physicians for suspicion of SAS.

Measurements: ONSI performed by nurses; overnight polysomnography. SAS was defined as an apnea-hypopnea index of 15 events or more per hour of sleep.

Results: A total of 121 consecutive patients were evaluated for study participation. Six were excluded because of technical difficulties with polysomnography or too-frequent awakenings related to medical conditions. One hundred eleven patients completed the validation process. Polysomnography identified 68 patients as having SAS and 43 patients as not having SAS. The nurse-administered ONSI demonstrated good levels of sensitivity (90%), specificity (81%), positive predictive value (88%), and negative predictive value (83%) in screening older adults for SAS.

Conclusion: The ONSI is the first valid SAS screening tool proposed for older persons in hospitals and nursing homes. This study demonstrates that the ONSI provides accurate information; is a simple, easy-to-use bed-side tool; and is highly sensitive and specific in screening SAS when compared with overnight polysomnography results.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Diagnostic Errors
  • Female
  • Humans
  • Male
  • Nursing Diagnosis*
  • Polysomnography / nursing*
  • Predictive Value of Tests
  • ROC Curve
  • Sensitivity and Specificity
  • Sleep Apnea Syndromes / diagnosis*
  • Sleep Apnea Syndromes / nursing