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Published in: Sleep and Breathing 3/2016

01-09-2016 | Hypoxia • Original Article

Feasibility of self-administered sleep assessment in older women in the Women’s Health Initiative (WHI)

Authors: Leslie Vaughan, Susan Redline, Katie Stone, Julianne Ulanski, Michael Rueschman, Heather Dailey, Stephen R. Rapp, Beverly M. Snively, Laura D. Baker, Sally A. Shumaker

Published in: Sleep and Breathing | Issue 3/2016

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Abstract

Purpose

Laboratory-based polysomnography (PSG) is the gold standard assessment of sleep disordered breathing (SDB). In large cohort studies and clinical trials, however, these overnight procedures can be expensive and burdensome to participants, especially older adults. In preparation for a large observational study, we determined the feasibility of self-administering two devices mailed to participants’ homes that estimate indices of SDB.

Methods

In two separate studies, older women enrolled in the Women’s Health Initiative (WHI) Memory Study extension aged mean (SD) 85.77 (2.98) years who were not using supplemental oxygen and consented to being in the feasibility study completed either an in-home, self-administered overnight sleep assessment using a multi-sensor device that measured oximetry, nasal pressure, chest effort, and snoring (ApneaLinkTM) (N = 58), or a wrist-worn oximeter (NoninWristOx2TM) (N = 33). A follow-up questionnaire assessed the devices’ acceptability and important sleep-related exposures.

Results

Although the multi-sensor device was assessed only in older women with no cognitive impairment, the proportion of completed interpretable sleep studies was low (54 %) and participants reported needing help to administer the device successfully. In contrast, the wrist-worn device was used in women with either no or mild cognitive impairment (MCI), completion rates were higher (100 %), and women reported being able to administer the device independently.

Conclusions

These studies demonstrated that home-based self-administered assessments of SDB are feasible in older adults with and without cognitive impairment using wrist-worn oximetry. These data support the feasibility of using simple oximetry measurements to provide indices of overnight intermittent hypoxemia in large observational studies and clinical trials.
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Literature
1.
2.
go back to reference Foley DJ, Monjan AA, Brown SL, Simonsick EM, Wallace RB, Blazer DG (1995) Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep 18(6):425–432PubMed Foley DJ, Monjan AA, Brown SL, Simonsick EM, Wallace RB, Blazer DG (1995) Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep 18(6):425–432PubMed
3.
go back to reference Ancoli-Israel S, Kripke DF (1991) Prevalent sleep problems in the aged. Biofeedback Self Regul 16(4):349–359CrossRefPubMed Ancoli-Israel S, Kripke DF (1991) Prevalent sleep problems in the aged. Biofeedback Self Regul 16(4):349–359CrossRefPubMed
4.
go back to reference Kushida CA, Littner MR, Morgenthaler T, Alessi CA, Bailey D, Coleman J Jr, Friedman L, Hirshkowitz M, Kapen S, Kramer M, Lee-Chiong T, Loube DL, Owens J, Pancer JP, Wise M (2005) Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep 28(4):499–521PubMed Kushida CA, Littner MR, Morgenthaler T, Alessi CA, Bailey D, Coleman J Jr, Friedman L, Hirshkowitz M, Kapen S, Kramer M, Lee-Chiong T, Loube DL, Owens J, Pancer JP, Wise M (2005) Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep 28(4):499–521PubMed
5.
go back to reference Garde A, Dehkordi P, Karlen W, Wensley D, Ansermino JM, Dumont GA (2014) Development of a screening tool for sleep disordered breathing in children using the phone Oximeter™. PLoS One 9(11):e112959, 1-15CrossRefPubMedPubMedCentral Garde A, Dehkordi P, Karlen W, Wensley D, Ansermino JM, Dumont GA (2014) Development of a screening tool for sleep disordered breathing in children using the phone Oximeter™. PLoS One 9(11):e112959, 1-15CrossRefPubMedPubMedCentral
6.
go back to reference Yaffe K, Laffan AM, Harrison SL et al (2011) Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA 306(6):613–619CrossRefPubMedPubMedCentral Yaffe K, Laffan AM, Harrison SL et al (2011) Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA 306(6):613–619CrossRefPubMedPubMedCentral
7.
go back to reference Gottlieb DJ, Yenokyan G, Newman AB et al (2010) Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation 122(4):352–360CrossRefPubMedPubMedCentral Gottlieb DJ, Yenokyan G, Newman AB et al (2010) Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation 122(4):352–360CrossRefPubMedPubMedCentral
8.
go back to reference Redline S, Yenokyan G, Gottlieb DJ, Shahar E, O’Connor GT, Resnick HE, Diener-West M, Sanders MH, Wolf PA, Geraghty EM, Ali T, Lebowitz M, Punjabi NM (2010) Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study. Am J Respir Crit Care Med 182(2):269–277CrossRefPubMedPubMedCentral Redline S, Yenokyan G, Gottlieb DJ, Shahar E, O’Connor GT, Resnick HE, Diener-West M, Sanders MH, Wolf PA, Geraghty EM, Ali T, Lebowitz M, Punjabi NM (2010) Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study. Am J Respir Crit Care Med 182(2):269–277CrossRefPubMedPubMedCentral
9.
go back to reference Epstein LJ, Kristo D, Strollo PJ, Friedman N, Malhotra A, Patil SP, Ramar K, Rogers R, Schwab RJ, Weaver EM, Weinstein MD, Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine (2009) Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 5(3):263–276PubMed Epstein LJ, Kristo D, Strollo PJ, Friedman N, Malhotra A, Patil SP, Ramar K, Rogers R, Schwab RJ, Weaver EM, Weinstein MD, Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine (2009) Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 5(3):263–276PubMed
10.
go back to reference Quan SF, Howard BV, Iber C et al (1997) The Sleep Heart Health Study: design, rationale, and methods. Sleep 20(12):1077–1085PubMed Quan SF, Howard BV, Iber C et al (1997) The Sleep Heart Health Study: design, rationale, and methods. Sleep 20(12):1077–1085PubMed
11.
go back to reference Mehra R, Stone KL, Blackwell T, Ancoli Israel S, Dam TT, Stefanick ML, Redline S (2007) Osteoporotic fractures in men study. Prevalence and correlates of sleep-disordered breathing in older men: osteoporotic fractures in men sleep study. J Am Geriatr Soc 55(9):1356–1364CrossRefPubMedPubMedCentral Mehra R, Stone KL, Blackwell T, Ancoli Israel S, Dam TT, Stefanick ML, Redline S (2007) Osteoporotic fractures in men study. Prevalence and correlates of sleep-disordered breathing in older men: osteoporotic fractures in men sleep study. J Am Geriatr Soc 55(9):1356–1364CrossRefPubMedPubMedCentral
12.
go back to reference Collop NA, Anderson WM, Boehlecke B, Claman D, Goldberg R, Gottlieb DJ, Hudgel D, Sateia M, Schwab R, Portable Monitoring Task Force of the American Academy of Sleep Medicine (2007) Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 3(7):737–747PubMed Collop NA, Anderson WM, Boehlecke B, Claman D, Goldberg R, Gottlieb DJ, Hudgel D, Sateia M, Schwab R, Portable Monitoring Task Force of the American Academy of Sleep Medicine (2007) Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 3(7):737–747PubMed
13.
go back to reference Spira AP, Blackwell T, Stone KL, Redline S, Cauley JA, Ancoli-Israel S, Yaffe K (2008) Sleep-disordered breathing and cognition in older women. J Am Geriatr Soc 56(1):45–50CrossRefPubMed Spira AP, Blackwell T, Stone KL, Redline S, Cauley JA, Ancoli-Israel S, Yaffe K (2008) Sleep-disordered breathing and cognition in older women. J Am Geriatr Soc 56(1):45–50CrossRefPubMed
14.
go back to reference Shumaker SA, Reboussin BA, Espeland MA, Rapp SR, McBee WL, Dailey M, Bowen D, Terrell T, Jones BN (1998) The Women’s Health Initiative Memory Study (WHIMS): a trial of the effect of estrogen therapy in preventing and slowing the progression of dementia. Control Clin Trials 19(6):604–621CrossRefPubMed Shumaker SA, Reboussin BA, Espeland MA, Rapp SR, McBee WL, Dailey M, Bowen D, Terrell T, Jones BN (1998) The Women’s Health Initiative Memory Study (WHIMS): a trial of the effect of estrogen therapy in preventing and slowing the progression of dementia. Control Clin Trials 19(6):604–621CrossRefPubMed
15.
go back to reference Chai-Coetzer CL, Antic NA, McEvoy RD (2013) Ambulatory models of care for obstructive sleep apnoea: diagnosis and management. Respirology 18(4):605–615CrossRefPubMed Chai-Coetzer CL, Antic NA, McEvoy RD (2013) Ambulatory models of care for obstructive sleep apnoea: diagnosis and management. Respirology 18(4):605–615CrossRefPubMed
Metadata
Title
Feasibility of self-administered sleep assessment in older women in the Women’s Health Initiative (WHI)
Authors
Leslie Vaughan
Susan Redline
Katie Stone
Julianne Ulanski
Michael Rueschman
Heather Dailey
Stephen R. Rapp
Beverly M. Snively
Laura D. Baker
Sally A. Shumaker
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Sleep and Breathing / Issue 3/2016
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-016-1314-3

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