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Master Thesis

Élaboration et évaluation pilote d'un nouvel outil de dépistage du syndrome d’apnées obstructives du sommeil en médecine générale : outil DHODS (diabète, hypertension, obésité, dyslipidémie, sommeil)

Abstract : Obstructive sleep apnea syndrome (OSA syndrome) would have a prevalence of 5% in the Western population, with a rising incidence. Only 10% to 20% would be diagnosed. However, existing treatments have proven to be effective in terms of reducing morbidity. Existing screening tools appear insufficiently known or unsuited to current practice. The main objective was to develop an OSA syndrome screening tool used during a routine act by the general practitioners. Secondary objectives were to assess its validity and feasibility. A screening tool called DHODS was created from data from the literature taking account comorbidities (diabetes, hypertension, obesity, dyslipidemia) partnering with 3 sleep issues: snoring, daytime sleepiness and poor quality of sleep. The screening was considered positive if the patient had at least 1 comorbidity and 2 symptoms. A multicenter prospective pilot study was conducted to assess the validity and feasibility of the tool. Inclusion criteria were to be 18 to 70 years and have at least one comorbidity. Exclusion criteria were known OSA. An explanatory brochure of OSA syndrome was proposed and a consultation with a sleep specialist. The primary outcome was a diagnosis of OSA syndrome according to the results of ventilator polygraphy. Between June and September 2014, 70 patients were included by 13 General Practitioners. Forty two consulted a pulmonologist; 35 patients were diagnosed OSA. On 32 apnea hypopnea index (AHI) submitted, 66% were moderate to severe OSAS 95% [48-80]. The positive predictive value (PPV) was 83.3%, 95% CI [69.4 to 91.7]. The PPV was comparable to other questionnaires validated in the literature. The DHODS seems efficient for improving OSA screening in primary care. It seems adapted to the practice because of rapid implementation and taking into account cardiovascular risk factors, well known by general practitioners. Further studies are needed to better assess its validity and feasibility.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01159288
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Submitted on : Wednesday, June 3, 2015 - 10:04:33 AM
Last modification on : Tuesday, May 11, 2021 - 11:36:18 AM
Long-term archiving on: : Monday, April 24, 2017 - 11:30:45 PM

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  • HAL Id : dumas-01159288, version 1

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Juliette Beguin Lecuyer, Jean-François Leignier. Élaboration et évaluation pilote d'un nouvel outil de dépistage du syndrome d’apnées obstructives du sommeil en médecine générale : outil DHODS (diabète, hypertension, obésité, dyslipidémie, sommeil). Médecine humaine et pathologie. 2015. ⟨dumas-01159288⟩

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