Prevalence of Obstructive Sleep Apnea in Patients with Chronic Wounds

Chronic non-healing wounds are a major health problem with steadily increasing importance.1 The prevalence of chronic leg ulcers is 3%–5% in the population over 65 years of age, with an increase of up to 12% in the population over 70 years of age.2 The most prevalent forms of chronic wounds are leg ulcers caused by chronic venous insufficiency(CVI)3–6 accounting for 70%-90% of ulcers found on the lower leg,7 followed by diabetic foot ulcers.8 Despite significant advances in knowledge, management of chronic wounds continues to involve frequent visits to wound centers and repeated interventions imposing significant burden on patients and society.3,9,10 Chronic wound ulcers are commonly associated with delayed healing requiring an average of 4-6 months, with a substantial number of patients failing to heal.11,12 The burden of chronic wounds is expected to be increasing in coming years with the increased aging and obesity of the population.2 Obstructive sleep apnea (OSA) is a disorder of intermittent hypoxia13–18 and severe vascular complications including hypertension, coronary disease, and stroke.19,22 OSA is present in 5%-10% of the middle-aged population and probably increasing in incidence due to the increasing obesity and age of the population.23 These are also the risk factors of chronic non-healing wounds.2 Therefore, it is very likely that patients with chronic wounds would have higher prevalence of OSA than the general population. We endeavored to characterize the risk factors for OSA in patients of academic wound center and to determine the actual prevalence of OSA in this population. BRIEF SUMMARY Current Knowledge/Study Rationale: Patients with non-healing wounds have high prevalence of cardiovascular disease and significant rate of healing failure. The prevalence of obstructive sleep apnea is unknown in this population. Study Impact: The study identifies a new population with very high pre-test probability for obstructive sleep apnea. Wound healing in this population may stand to benefit from expedited surveillance and treatment strategies for OSA.