Sleep disordered breathing in adult with polio sequelae: A case control study of predictive factors

Introduction/Background Estimates of sleepdisorder breathing(SDB) prevalence are higher in patients with polio sequelae than in general population, ranging from 50% to 65%. No specific predictive factors have been described in our knowledge. The aim of this study was to identify SDB predictive factors among polio survivors. Material and method A case control study including patients with polio sequelae with confirmed SDB ( apnea hypopnea index(AHI) ≥ 5; n = 38) compared to polio patients with AHI ≤ 5 or negative Berlin questionnaire ( n = 114). Matching criteria were: sex, age at evaluation, and body mass index (BMI). For each patient, age at acute polio, bulbar, trunk, and lower limbs involvement, scoliosis, current walking abilities and history of arthrodesis, brace or iron lungwere assessed using preexisting database and medical charts. SDB symptoms, Berlin questionnaire and AHI using polysomnographic reports were also assessed retrospectively. Results Among the 362 polio patients from our systematic database 152 (38 cases and 114 controls) were matched for comparison. SDB ratio was significantly higher in patients with bulbar involvement at acute polio (100% vs. 22.5%), trunk involvement at acute polio (41.9% vs. 18.4%), bulbar involvement at evaluation (100% vs. 23%), scoliosis(38.6% vs. 13.8%) and non-walking patients (50% vs. 22.5%) compared with polio controls. Multivariate analysis only shown scoliosisto be associated with SDB in those patients (OR = 2.72 (95% CI: 1.10–6.95); P = 0.03). Conclusion Despite there was an increased ratio of SDB in patients with bulbar and trunk involvement, only scoliosisseems to specifically increase the risk of SDB occurrence among polio survivors. In those patients, symptoms suggestive of SDB should be searched for systematically, especially in case of trunk deformities.