Idiopathic normal-pressure hydrocephalus and obstructive sleep apnea are frequently associated: A prospective cohort study
Idiopathic normal-pressure hydrocephalus (iNPH) is defined by ventriculomegaly, cognitive decline, urinary incontinence and gait problems. Vascular risk factors (VRF) are associated with iNPH but obstructive sleep apnea (OSA) —a well-known independent VRF— is seldom mentioned. We investigated the pr...
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| Veröffentlicht in: | Journal of the neurological sciences 2018-12, Vol.395, p.164-168 |
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| container_title | Journal of the neurological sciences |
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| creator | Román, Gustavo C. Verma, Aparajitha K. Zhang, Y. Jonathan Fung, Steve H. |
| description | Idiopathic normal-pressure hydrocephalus (iNPH) is defined by ventriculomegaly, cognitive decline, urinary incontinence and gait problems. Vascular risk factors (VRF) are associated with iNPH but obstructive sleep apnea (OSA) —a well-known independent VRF— is seldom mentioned.
We investigated the presence of sleep-disordered breathing in a prospective cohort of 31 consecutive unselected patients with iNPH using sleep questionnaires and nocturnal polysomnography (PSG).
We found OSA in 90·3% (28/31) patients with iNPH; all had undiagnosed sleep abnormalities (snoring, awakenings, nocturia) and excessive daytime sleepiness (Epworth scale = 11·4 ± 6·4; normal 25- |
| doi_str_mv | 10.1016/j.jns.2018.10.005 |
| format | Article |
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We investigated the presence of sleep-disordered breathing in a prospective cohort of 31 consecutive unselected patients with iNPH using sleep questionnaires and nocturnal polysomnography (PSG).
We found OSA in 90·3% (28/31) patients with iNPH; all had undiagnosed sleep abnormalities (snoring, awakenings, nocturia) and excessive daytime sleepiness (Epworth scale = 11·4 ± 6·4; normal <8). Nocturnal PSG showed moderate-to-severe OSA in 25 patients (80·6%) with mean apnea-hypopnea index (AHI) 31·6 ± 23·6/h; mean respiratory distress index (RDI) 34·5/h; and, mean SaO2 desaturation at nadir, 82·2 ± 7·5%. The observed OSA prevalence is statistically significant: 90·3%, 95%CI 74·3–97·5; p = 0·000007. Other VRF included overweight body-mass index (BMI >25- < 30 kg/m2) in 59%, hyperhomocysteinemia 57%, hypertension 43%, hyperlipidemia 39%, diabetes 32%, smoking 21%, coronary disease 18%, and previous stroke 10%.
Abnormal sleep breathing is frequently associated with iNPH. Validation in larger series is required but we suggest including sleep evaluation in patients suspected of iNPH.
•Multiple vascular risk factors (VRFs) often occur in idiopathic normal-pressure hydrocephalus (iNPH).•Obstructive sleep apnea (OSA) is an independent vascular risk factor rarely reported in iNPH.•Sleep was studied in a prospective cohort of 31 consecutive patients with iNPH from a single memory clinic.•Nocturnal polysomnogram confirmed OSA in 90·3% (28/31) patients with iNPH; all had undiagnosed sleep abnormalities and excessive daytime sleepiness.•Larger confirmatory studies are needed but it appears reasonable to obtain a sleep history in patients suspected of iNPH.</description><identifier>ISSN: 0022-510X</identifier><identifier>EISSN: 1878-5883</identifier><identifier>DOI: 10.1016/j.jns.2018.10.005</identifier><identifier>PMID: 30340088</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Aged ; Female ; Humans ; Hydrocephalus, Normal Pressure - epidemiology ; Hydrocephalus, Normal Pressure - physiopathology ; Male ; Normal-pressure hydrocephalus ; Obstructive sleep apnea ; Polysomnography ; Prevalence ; Prospective Studies ; Risk Factors ; Severity of Illness Index ; Sleep Apnea, Obstructive - epidemiology ; Sleep Apnea, Obstructive - physiopathology ; Sleep-disordered breathing ; Vascular risk factors</subject><ispartof>Journal of the neurological sciences, 2018-12, Vol.395, p.164-168</ispartof><rights>2018</rights><rights>Copyright © 2018. Published by Elsevier B.V.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-95f6dde21bc217556eb605e401e5fef745ed7afe100a45685bae69a2541f4bc3</citedby><cites>FETCH-LOGICAL-c419t-95f6dde21bc217556eb605e401e5fef745ed7afe100a45685bae69a2541f4bc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022510X18304167$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30340088$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Román, Gustavo C.</creatorcontrib><creatorcontrib>Verma, Aparajitha K.</creatorcontrib><creatorcontrib>Zhang, Y. Jonathan</creatorcontrib><creatorcontrib>Fung, Steve H.</creatorcontrib><title>Idiopathic normal-pressure hydrocephalus and obstructive sleep apnea are frequently associated: A prospective cohort study</title><title>Journal of the neurological sciences</title><addtitle>J Neurol Sci</addtitle><description>Idiopathic normal-pressure hydrocephalus (iNPH) is defined by ventriculomegaly, cognitive decline, urinary incontinence and gait problems. Vascular risk factors (VRF) are associated with iNPH but obstructive sleep apnea (OSA) —a well-known independent VRF— is seldom mentioned.
We investigated the presence of sleep-disordered breathing in a prospective cohort of 31 consecutive unselected patients with iNPH using sleep questionnaires and nocturnal polysomnography (PSG).
We found OSA in 90·3% (28/31) patients with iNPH; all had undiagnosed sleep abnormalities (snoring, awakenings, nocturia) and excessive daytime sleepiness (Epworth scale = 11·4 ± 6·4; normal <8). Nocturnal PSG showed moderate-to-severe OSA in 25 patients (80·6%) with mean apnea-hypopnea index (AHI) 31·6 ± 23·6/h; mean respiratory distress index (RDI) 34·5/h; and, mean SaO2 desaturation at nadir, 82·2 ± 7·5%. The observed OSA prevalence is statistically significant: 90·3%, 95%CI 74·3–97·5; p = 0·000007. Other VRF included overweight body-mass index (BMI >25- < 30 kg/m2) in 59%, hyperhomocysteinemia 57%, hypertension 43%, hyperlipidemia 39%, diabetes 32%, smoking 21%, coronary disease 18%, and previous stroke 10%.
Abnormal sleep breathing is frequently associated with iNPH. Validation in larger series is required but we suggest including sleep evaluation in patients suspected of iNPH.
•Multiple vascular risk factors (VRFs) often occur in idiopathic normal-pressure hydrocephalus (iNPH).•Obstructive sleep apnea (OSA) is an independent vascular risk factor rarely reported in iNPH.•Sleep was studied in a prospective cohort of 31 consecutive patients with iNPH from a single memory clinic.•Nocturnal polysomnogram confirmed OSA in 90·3% (28/31) patients with iNPH; all had undiagnosed sleep abnormalities and excessive daytime sleepiness.•Larger confirmatory studies are needed but it appears reasonable to obtain a sleep history in patients suspected of iNPH.</description><subject>Aged</subject><subject>Female</subject><subject>Humans</subject><subject>Hydrocephalus, Normal Pressure - epidemiology</subject><subject>Hydrocephalus, Normal Pressure - physiopathology</subject><subject>Male</subject><subject>Normal-pressure hydrocephalus</subject><subject>Obstructive sleep apnea</subject><subject>Polysomnography</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Sleep Apnea, Obstructive - epidemiology</subject><subject>Sleep Apnea, Obstructive - physiopathology</subject><subject>Sleep-disordered breathing</subject><subject>Vascular risk factors</subject><issn>0022-510X</issn><issn>1878-5883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFu3CAURVHVqpmk_YBuIpbZePLAxmaaVRS1TaRI3WTRHcLwrGHkMQ4PR5p8fRhN2mVXCHTu1eUw9k3AWoBor3fr3URrCUKX-xpAfWAroTtdKa3rj2wFIGWlBPw5Y-dEOwBotd58Zmc11A2A1iv2-uBDnG3eBsenmPZ2rOaEREtCvj34FB3OWzsuxO3keewpp8Xl8IKcRsSZ23lCy22hh4TPC055PHBLFF2wGf13fsvnFGnGU8jFbUyZU1784Qv7NNiR8Ov7ecGefv54uruvHn__eri7faxcIza52qih9R6l6J0UnVIt9i0obECgGnDoGoW-swMKANuoVqveYruxUjViaHpXX7CrU23ZUQZSNvtADsfRThgXMlLIuhNaKiioOKGuTKaEg5lT2Nt0MALM0bjZmWLcHI0fn4rxkrl8r1_6Pfp_ib-KC3BzArD88SVgMuQCTg59SMWK8TH8p_4NhJSU5A</recordid><startdate>20181215</startdate><enddate>20181215</enddate><creator>Román, Gustavo C.</creator><creator>Verma, Aparajitha K.</creator><creator>Zhang, Y. Jonathan</creator><creator>Fung, Steve H.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20181215</creationdate><title>Idiopathic normal-pressure hydrocephalus and obstructive sleep apnea are frequently associated: A prospective cohort study</title><author>Román, Gustavo C. ; Verma, Aparajitha K. ; Zhang, Y. Jonathan ; Fung, Steve H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-95f6dde21bc217556eb605e401e5fef745ed7afe100a45685bae69a2541f4bc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Female</topic><topic>Humans</topic><topic>Hydrocephalus, Normal Pressure - epidemiology</topic><topic>Hydrocephalus, Normal Pressure - physiopathology</topic><topic>Male</topic><topic>Normal-pressure hydrocephalus</topic><topic>Obstructive sleep apnea</topic><topic>Polysomnography</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Sleep Apnea, Obstructive - epidemiology</topic><topic>Sleep Apnea, Obstructive - physiopathology</topic><topic>Sleep-disordered breathing</topic><topic>Vascular risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Román, Gustavo C.</creatorcontrib><creatorcontrib>Verma, Aparajitha K.</creatorcontrib><creatorcontrib>Zhang, Y. Jonathan</creatorcontrib><creatorcontrib>Fung, Steve H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Román, Gustavo C.</au><au>Verma, Aparajitha K.</au><au>Zhang, Y. Jonathan</au><au>Fung, Steve H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Idiopathic normal-pressure hydrocephalus and obstructive sleep apnea are frequently associated: A prospective cohort study</atitle><jtitle>Journal of the neurological sciences</jtitle><addtitle>J Neurol Sci</addtitle><date>2018-12-15</date><risdate>2018</risdate><volume>395</volume><spage>164</spage><epage>168</epage><pages>164-168</pages><issn>0022-510X</issn><eissn>1878-5883</eissn><abstract>Idiopathic normal-pressure hydrocephalus (iNPH) is defined by ventriculomegaly, cognitive decline, urinary incontinence and gait problems. Vascular risk factors (VRF) are associated with iNPH but obstructive sleep apnea (OSA) —a well-known independent VRF— is seldom mentioned.
We investigated the presence of sleep-disordered breathing in a prospective cohort of 31 consecutive unselected patients with iNPH using sleep questionnaires and nocturnal polysomnography (PSG).
We found OSA in 90·3% (28/31) patients with iNPH; all had undiagnosed sleep abnormalities (snoring, awakenings, nocturia) and excessive daytime sleepiness (Epworth scale = 11·4 ± 6·4; normal <8). Nocturnal PSG showed moderate-to-severe OSA in 25 patients (80·6%) with mean apnea-hypopnea index (AHI) 31·6 ± 23·6/h; mean respiratory distress index (RDI) 34·5/h; and, mean SaO2 desaturation at nadir, 82·2 ± 7·5%. The observed OSA prevalence is statistically significant: 90·3%, 95%CI 74·3–97·5; p = 0·000007. Other VRF included overweight body-mass index (BMI >25- < 30 kg/m2) in 59%, hyperhomocysteinemia 57%, hypertension 43%, hyperlipidemia 39%, diabetes 32%, smoking 21%, coronary disease 18%, and previous stroke 10%.
Abnormal sleep breathing is frequently associated with iNPH. Validation in larger series is required but we suggest including sleep evaluation in patients suspected of iNPH.
•Multiple vascular risk factors (VRFs) often occur in idiopathic normal-pressure hydrocephalus (iNPH).•Obstructive sleep apnea (OSA) is an independent vascular risk factor rarely reported in iNPH.•Sleep was studied in a prospective cohort of 31 consecutive patients with iNPH from a single memory clinic.•Nocturnal polysomnogram confirmed OSA in 90·3% (28/31) patients with iNPH; all had undiagnosed sleep abnormalities and excessive daytime sleepiness.•Larger confirmatory studies are needed but it appears reasonable to obtain a sleep history in patients suspected of iNPH.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>30340088</pmid><doi>10.1016/j.jns.2018.10.005</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Female Humans Hydrocephalus, Normal Pressure - epidemiology Hydrocephalus, Normal Pressure - physiopathology Male Normal-pressure hydrocephalus Obstructive sleep apnea Polysomnography Prevalence Prospective Studies Risk Factors Severity of Illness Index Sleep Apnea, Obstructive - epidemiology Sleep Apnea, Obstructive - physiopathology Sleep-disordered breathing Vascular risk factors |
| title | Idiopathic normal-pressure hydrocephalus and obstructive sleep apnea are frequently associated: A prospective cohort study |
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