Agreement between stroke patients and family members for ascertaining pre-stroke risk for sleep apnea

Abstract

Background Ascertaining self-reported information about pre-stroke obstructive sleep apnea (OSA) risk in the acute stroke period is challenging as many stroke patients have deficits that hinder communication. We examined agreement between stroke patients without communication limitations and family members (proxy) with respect to pre-stroke risk of OSA. Methods Patient-proxy pairs (n = 42) were interviewed independently as part of the Brain Attack Surveillance in Corpus Christi Project from May 2010 - April 2011. The Berlin questionnaire was used to measure a high risk of OSA defined as the presence of at least two of the following conditions: 1) snoring behaviors/witnessed apneas, 2) daytime sleepiness, and 3) hypertension or obesity. Patient-proxy agreement was assessed using a kappa coefficient. Results Forty-three percent of patients self-identified as high risk for sleep apnea, and 45% of proxies identified patients as high risk. Patient-proxy agreement for high risk of pre-stroke OSA was fair (kappa = 0.28) with better agreement for spouses and children proxies (kappa = 0.38) than for other family members. Agreement was also fair for most individual questions. Conclusions Spouse and child proxy use of the Berlin questionnaire may be an option to assess a patient's pre-stroke likelihood of sleep apnea. Whereas prospective studies of incident stroke in patients with and without objectively confirmed sleep apnea would require formidable resources, the present results suggest that an alternative strategy may involve proxy use of the Berlin in a retrospective study design.

Eight-Section Brocade Exercises Improve the Sleep Quality and Memory Consolidation and Cardiopulmonary Function of Older Adults With Atrial Fibrillation-Associated Stroke

“…We chose the baseline characteristics [age (Hokett and Duarte, 2019; Scullin et al, 2019), gender (Spencer, 2008), high blood pressure (Borda et al, 2019; Kumar et al, 2019), high blood lipids (Reijmer et al, 2009; Kruisbrink et al, 2017), diabetes (Margolis et al, 2019; Zhu et al, 2019), being overweight (Mora-Gonzalez et al, 2019; Yeo et al, 2019), atrial fibrillation (Takii et al, 2016; Yeung et al, 2019), smoking (Blaes et al, 2019; Cohen et al, 2019), family history of stroke (Baumann et al, 2012; Reeves et al, 2014), and history of transient ischemic attack (Takahashi et al, 2009; Sico et al, 2017)] according to previous reports indicating that these parameters would affect sleep and memory. The statistical difference for baseline characteristics was insignificant between the two groups (Table 1, p > 0.05).…”

Análise da prevalência de perda auditiva autodeclarada e fatores associados: informante primário versus proxy

“…Estudos que avaliam a confiabilidade entre as respostas de informantes proxy e informante primário, em outras áreas, como doenças cardiovasculares e qualidade de vida, têm encontrado concordâncias de excelente 18 para moderada a substancial 19 , e aceitável 20 . Sendo que os autores referem a importância do uso de informantes proxy para evitar a perda de informações sobre outros sujeitos.…”

Prevalence of pre-stroke sleep apnea risk and short or long sleep duration in a bi-ethnic stroke population

“…However, bed partner responses to the Berlin questionnaire may predict sleep apnea based on polysomnographic criteria better than the patient, there is fair patient-proxy agreement for high risk pre-stroke SA based on Berlin questionnaire, and no ethnic difference in the use of proxies was identified (p=0.30). [17, 18] Self-report of sleep duration is variably correlated with more objective measures of total sleep time, and may better reflect other constructs such as sleep quality or time in bed.…”