Researchers at the University of Saskatchewan took on a folksy question when they attempted to determine the “utility of the elbow” as an OSA predictor.
Mark E. Fenton, MD, along with six other researchers, sifted through multiple questionnaires, zeroing in on two questions: 1) Does your bed partner ever poke or elbow you because you are snoring?; and 2) Does your bed partner ever poke or elbow you because you have stopped breathing?
Researchers specifically sought to determine whether a simple two-part questionnaire has predictive value in the pretest clinical evaluation for OSA. The two questionnaires were prospectively administered to patients evaluated in a sleep disorders clinic prior to undergoing polysomnography. Age, sex, BMI, and Epworth Sleepiness Scale data were collected.
The study titled “The Utility of the Elbow Sign in the Diagnosis of OSA” is published in the recent edition of CHEST from the American College of Chest Physicians. According to the abstract, among the 128 patients who had a polysomnogram, answering “yes” to being awakened for snoring increased the OR of an apnea-hypopnea index ≥ 5/h 3.9 times compared with “no.” Answering “yes” to being awakened for apneic spells was associated with an OR of 5.8 for an apnea-hypopnea index ≥ 5/h compared with “no.”
“These associations did not differ by sex, BMI, Epworth Sleepiness Scale or answering ‘yes’ to the other question,” write researchers in the abstract. “Subjects > 50 years old with OSA were less likely to report a positive elbow sign and had a significantly lower OR for being awakened for apneic spells than those < 50 years old…Among patients referred to a sleep disorders clinic, a positive response to being elbowed/poked for apneic spells significantly improves the pretest prediction of OSA.”