Biomedical subjects

V Ferrette

Publications and source records attributed to V Ferrette.

4 recordsLinked to original sources

PubMed1996

The association of sudden unexpected infant death with obstructive sleep apnea.

We studied the relationship of sudden unexpected infant death/apparent life-threatening events (ALTE) to obstructive sleep apnea (OSA) in 74 index probands who had either sleep-laboratory-confirmed OSA or a clinical diagnosis of OSA requiring treatment, 62 matched control probands, and their spouses and first- and second-degree relatives. Sleep was monitored in the home overnight, and OSA was defined by respiratory disturbance indices (number of apneas/hypopneas per hour of sleep) corrected for normal increases with age. Information on sudden unexpected infant death/ALTE was obtained by questionnaire and was corroborated. For living relatives, data were obtained by questionnaire, examination, or study (cephalometric radiographs, ventilatory responsiveness to hypercapnia and hypoxia). Eight index families had 10 infants with sudden unexpected infant death/ALTE; two control families had three infants with sudden death (p = 0.11). All told, 91 of the 136 families (index plus control) included members with OSA, and all 10 infant death/ALTE families were among these (versus zero of 45 families with no OSA; p = 0.03). The sudden infant death/ALTE families had a greater frequency of two or more members with OSA (p = 0.06), reported more respiratory disease or allergy, were more frequently brachycephalic (p = 0.05), and had a smaller mean posterior nasal spine-basion distance (p = 0.0001) and ratio of anterior mandibular/anterior maxillary dental height (p < 0.05). Ventilatory responses to hypoxia were reduced in members of families with OSA (p = 0.008), with a trend toward the greatest blunting in subjects from families with OSA plus sudden unexpected infant death/ALTE. Thus, OSA in adults and sudden unexpected infant death/ALTE in their biologic relatives appear to be related. Familial factors influencing this association may include the degree of the predilection for OSA, liability for respiratory illness or allergy, dimensions of the oral-pharyngeal airway, and ventilatory response to hypoxia.

Case-Control Studies↗

PubMed1995

The familial aggregation of obstructive sleep apnea.

An inherited basis for sleep-disordered breathing (SDB) has been suggested by reports of families with multiple affected members and by a previous study of the familial aggregation of symptoms of SDB. In this study, we quantify and characterize the aggregation of SDB and assess the degree to which familial similarities may be independent of obesity. This was a genetic-epidemiologic study that assessed the distribution of SDB in families identified through a proband with diagnosed sleep apnea and among families in the same community with no relative with known sleep apnea. SDB was assessed with overnight in-home monitoring of airflow, oxygen saturation, chest wall impedance, heart rate, and body movement. Standardized questionnaires were used to assess symptoms, and weight, height, and neck circumference were measured directly. Intergenerational and intragenerational correlation coefficients and pairwise odds ratios (ORs) were calculated with adjustment for proband sampling. In toto, 561 members of 91 families were studied: (1) 47 subjects with laboratory-confirmed SDB (index probands), (2) 44 community control subjects, and (3) the spouses and relatives of 1 and 2. Of all 91 families, 32 (35%) had two or more members with SDB, 30 (33%) had one affected member, and 29 had no affected members. SDB was more prevalent in the relatives of index probands (21%) than among neighborhood control subjects (12%) (p = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

Gender differences in sleep disordered breathing in a community-based sample.

Gender differences in the relative frequency of sleep-disordered breathing (SDB) have been observed in surveys of patient groups referred for clinical evaluation compared with population surveys. In this study, we assessed the associations of gender, SDB, and symptoms of SDB in 389 participants (16 to 84 yr of age) in an ongoing genetic-epidemiologic study of sleep apnea. Subjects included index probands with laboratory-confirmed obstructive sleep apnea syndrome (laboratory sample, n = 36) and their family members and neighbors (the community sample). SDB was assessed with overnight in-home monitoring of airflow, oximetry, heart rate, and chest wall impedance, and symptoms were assessed with standardized questionnaires. In the entire sample, SDB, defined as a respiratory disturbance index [RDI] > or = 15, was more prevalent among males (38%) than among females (15%) (p < 0.05). Males predominated by a ratio of 8:1 in the laboratory sample (31 males, five females). In contrast, the proportion of males to females with SDB was only 2:1 in the community sample, in which an RDI > or = 15 was observed among 26% of males and 13% of females. In the laboratory sample, females tended to be younger and were significantly heavier than males. However, in the community sample, females with SDB were older than male apneic subjects (63.4 +/- 13.9 versus 47.2 +/- 15.6 years, mean +/- SD; p < 0.01), and included a majority of postmenopausal women (75%). No differences in body mass index were noted between males and females with SDB recruited from the community.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1994

Assessment of the validity and utility of a sleep-symptom questionnaire.

Although questionnaires have been developed to assess symptoms of obstructive sleep apnea (OSA), their overall reliability and utility have not been established. We have evaluated the ability of a questionnaire to identify increased apnea activity (IAA) in 465 participants in an epidemiologic study of OSA. Subjects and their roommates each completed a questionnaire and underwent in-home sleep studies. Responses to 56 questions about sleep habits, sleepiness, and daytime performance were analyzed with factor analysis, logistic regression, and receiver-operator curves (ROCs). Factor analysis demonstrated that 16 questions, grouped into five factors (functional impact of sleepiness, self-reported breathing disturbances, roommate-observed breathing disturbances, driving impairment, and insomnia) explained 67% of the variance in the questionnaire data. Symptom questions demonstrated internal consistency (Cronbach correlations: 0.91 to 0.98). Moderate levels of agreement were observed between self- and roommate-reported responses for nine of ten questions asked of both the subject and his/her partner (kappa statistics: 0.34 to 0.57). Logistic regression analysis demonstrated that IAA could be best predicted by three questions about intensity of snoring, roommate-observed choking, and having fallen asleep while driving (ROC area: 0.78). Use of symptoms with data on gender and body mass index (BMI) improved predictive ability by 10% (ROC area: 0.87). Thus, questionnaire data provide a valid means of characterizing symptom distributions in population surveys of OSA. Predictive ability is not significantly improved with multiple questions or a separate roommate questionnaire, but is improved with consideration of data on BMI and gender.

Adult↗