Chest
Clinical InvestigationsDaytime Sleepiness and Vascular Morbidity at Seven-Year Follow-up in Obstructive Sleep Apnea Patients
Section snippets
METHODS
Criteria for Inclusion in the Study
Before searching our clinic records to form two retrospective cohorts of surgically (tracheostomy) and conservatively treated patients, we established the following requirements for subjects:
- 1.
Residence in a western state of the United States (California, Nevada, Arizona, Oregon, or Washington), to facilitate follow-up.
- 2.
A previous polygraphic monitoring, with sufficient information in the chart to calculate AI. (Hypopneas or partial obstruction of the upper
Total Population
The initially seen population included 198 patients described in Table 1. At entry, 112 patients (56.6 percent) presented with arterial hypertension. Coronary artery disease had been diagnosed in 33 (16.7 percent) patients (31 men, two women). Previous medical history noted myocardial infarction in 16 (8.1 percent) and stroke in 14 (7.1 percent). Chronic obstructive pulmonary disease was found in 40 cases (20 percent) and EDS in 173 (87.4 percent) patients (Fig 1).
Description of the Two Subgroups
The conservatively treated
DISCUSSION
Our report presents a prospective follow-up study based on two retrospectively selected cohorts of patients, seen as early as 1972 when tracheostomy was the only surgical treatment9 and weight-loss recommendation the only alternative. This is a so-called “Trohort-Cohort” study that will always be weaker than a prospective investigation and that may ignore some issues. At that time, when OSAS (ie, association of clinical complaints with polygraphic finding) was less commonly recognized, patients
ACKNOWLEDGMENTS
We thank Boyd Hayes for providing technical assistance and Alison Grant for editing the manuscript.
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This work was supported by grant AC07772 from the National Institute of Aging; by the Miina Sillanpaä and Sigrid Juselius Foundations of Helsinki, Finland; and US Public Health Service International Research Fellowship 1 FO 5TW03648-01.
Manuscript received January 9; revision accepted May 17.