Obstructive Sleep Apnea: Value of Being Elbowed by Bed-Partner

M.E. Fenton MD MSc FRCPC FCCP Associate Professor Program Director, Respirology Training Program Division of Respirology, Critical Care and Sleep Medicine University of SaskatchewanMedicalResearch.com Interview Invitation
M.E. Fenton MD MSc FRCPC FCCP
Associate Professor
Program Director, Respirology Training Program
Division of Respirology, Critical Care and Sleep Medicine
University of Saskatchewan

MedicalResearch.com: What are the main findings of the study?

Dr. Fenton: This study demonstrates that asking a simple question in the outpatient clinic – Does your bed-partner ever poke or elbow you because you have stopped breathing? – has significant predictive value for a diagnosis of obstructive sleep apnea.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Fenton: Prior to doing this study, we had observed that many patients being evaluated for obstructive sleep apnea (OSA) report this phenomenon in the outpatient clinic, so we were not surprised that the Elbow Sign has predictive value in diagnosing OSA.  However, we were pleasantly surprised at the high specificity (96.6%) demonstrated in men who have a body mass index of 31 or higher.  This is the most common demographic being assessed for OSA and the possibility of making a diagnosis without a polysomnogram is exciting, as there are long wait times for such testing in many jurisdictions.

MedicalResearch.com: What should clinicians take away from your report?

Dr. Fenton: The primary message is that in a Sleep Disorders Clinic a positive Elbow Sign has high predictive value for a diagnosis of OSA, particularly in obese men.  The other, more controversial, message is that this study suggests that not all patients being evaluated for OSA need a diagnostic test (e.g. polysomnogram) to make the diagnosis.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Fenton: This is a single center study and needs to be validated more broadly.

Citation:

The Utility of the Elbow Sign in the diagnosis of Obstructive Sleep Apnea

Mark E. Fenton, MD, FCCP; Karen Heathcote, MD; Rhonda Bryce, MD; Robert Skomro, MD, FCCP; John K. Reid, MD, FCCP; John Gjevre, MD, FCCP; David Cotton, MD, FCCP
Chest. 2013. doi:10.1378/chest.13-1046

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