Obstructive Sleep Apnea – Clinical predictors and correlation with questionaires
DOI:
https://doi.org/10.34631/sporl.1022Keywords:
Obstructive sleep apnea, OSA, obstructive sleep apnea syndrome, Polysomnography, QuestionnaireAbstract
Objectives: To analyse epidemiological, demographic and clinical factors that may be related to Obstructive Sleep Apnea (OSA). To evaluate the correlation between several questionnaires (Epworth Sleepiness Scale, STOP-Bang and Berlin Questionnaires) with polysomnography (PSG) results, in order to apply them as a tool for selecting patients for PSG.
Material and Methods: Prospective study. Completion of questionnaires at the time of the type III PSG study, at the Otorhinolaryngology Department of Hospital Garcia de Orta and review of the patient clinical file.
Results: 193 patients were evaluated, with a mean age of 57(±14) years, 57.5% were male. Age (p = 0.001), BMI (p = 0.001), the presence of arterial hypertension (p = 0.006) and diabetes mellitus (p = 0.003) were found to be factors associated with the presence of OSA. Of the three questionnaires tested, only the STOP-Bang questionnaire showed a statistically significant correlation with the presence of OSA (p = 0.001) in the population studied. Analysing the ROC curves, the STOP-Bang questionnaire showed the best discriminative capacity for the presence of OSA (0.853 p = 0.001), followed by the Berlin questionnaire (0.659 p = 0.002) and finally the Epworth sleepiness scale (0.559 p = 0.257).
Conclusions: The STOP-Bang was the questionnaire that demonstrated a significant correlation with the presence of OSA, constituting a useful tool, particularly in the context of in-office consultation, for the selection and referral of patients for PSG study.
References
Balachandran JS, Patel SR. In the clinic. Obstructive sleep apnea. Ann Intern Med. 2014 Nov 4;161(9):ITC1-15; quiz ITC16. doi: 10.7326/0003-4819-161-9-201411040-01005.
Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, Matheson MC. et al. Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep Med Rev. 2017 Aug;34:70-81. doi: 10.1016/j.smrv.2016.07.002.
Senaratna CV, Perret JL, Matheson MC, Lodge CJ, Lowe AJ, Cassim R. et al. Validity of the Berlin questionnaire in detecting obstructive sleep apnea: A systematic review and meta-analysis. Sleep Med Rev. 2017 Dec;36:116-124. doi: 10.1016/j.smrv.2017.04.001.
Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K. et al. Clinical practice Gguideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017 Mar 15;13(3):479-504. doi: 10.5664/jcsm.6506.
Gottlieb DJ, Punjabi NM. Diagnosis and management of obstructive sleep apnea: a review. JAMA. 2020 Apr 14;323(14):1389-1400. doi: 10.1001/jama.2020.3514.
Jonas DE, Amick HR, Feltner C, Weber RP, Arvanitis M, Stine A. et al. Screening for obstructive sleep apnea in adults: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2017 Jan 24;317(4):415-433. doi: 10.1001/jama.2016.19635.
Chiu HY, Chen PY, Chuang LP, Chen NH, Tu YK, Hsieh YJ. et al. Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: A bivariate meta-analysis. Sleep Med Rev. 2017 Dec;36:57-70. doi: 10.1016/j.smrv.2016.10.004.
Lim DC, Pack AI. Obstructive sleep apnea: update and future. Annu Rev Med. 2017 Jan 14;68:99-112. doi: 10.1146/annurev-med-042915-102623.
Rodrigues AP, Pinto P, Nunes B, Bárbara C. Síndrome de apneia obstrutiva do sono: epidemiologia, diagnóstico e tratamento. Um estudo da Rede Médicos-Sentinela. [Internet] Lisboa: Direção Geral da Saúde; 2014. Available from:http://hdl.handle.net/10400.18/2686
Zheng Z, Sun X, Chen R, Lei W, Peng M, Li X. et al. Comparison of six assessment tools to screen for obstructive sleep apnea in patients with hypertension. Clin Cardiol. 2021 Nov;44(11):1526-1534. doi: 10.1002/clc.23714.
Prasad KT, Sehgal IS, Agarwal R, Nath Aggarwal A, Behera D, Dhooria S. Assessing the likelihood of obstructive sleep apnea: a comparison of nine screening questionnaires. Sleep Breath. 2017 Dec;21(4):909-917. doi: 10.1007/s11325-017-1495-4.
Caselhos S, Teles RV, Matos C, Fernandes F. Síndrome de apneia obstrutiva do sono: nove anos de experiência. Revista Portuguesa Otorrinolaringologia e Cirurgia de Cabeça e Pescoço. 2011;49(2):85-90. doi: https://doi.org/10.34631/sporl.162.
Vaz AP, Drummond M, Mota PC, Severo M, Almeida J, Winck JC. Tradução do Questionário de Berlim para língua Portuguesa e sua aplicação na identificação da SAOS numa consulta de patologia respiratória do sono. Rev Port Pneumol. 2011 Mar-Apr;17(2):59-65. doi:10.1016/S0873-2159(11)70015-0
Amra B, Javani M, Soltaninejad F, Penzel T, Fietze I, Schoebel C. et al. Comparison of Berlin Questionnaire, STOP-Bang, and Epworth Sleepiness Scale for diagnosing obstructive sleep apnea in persian patients. Int J Prev Med. 2018 Mar 9;9:28. doi: 10.4103/ijpvm.IJPVM_131_17.
Herschmann S, Berger M, Haba-Rubio J, Heinzer R. Comparison of NoSAS score with Berlin and STOP-BANG scores for sleep apnea detection in a clinical sample. Sleep Med. 2021 Mar;79:113-116. doi: 10.1016/j.sleep.2021.01.004
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