Prediction of obstructive sleep apnea: comparative performance of three screening instruments on the apnea-hypopnea index and the oxygen desaturation index

Christianne C.A.F.M. Veugen*, Emma M. Teunissen, Leontine A.S. den Otter, Martijn P. Kos, Robert J. Stokroos, Marcel P. Copper

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
6 Downloads (Pure)

Abstract

Purpose: To evaluate the performance of the NoSAS (neck, obesity, snoring, age, sex) score, the STOP-Bang (snoring, tiredness, observed apneas, blood pressure, body mass index, age, neck circumference, gender) questionnaire, and the Epworth sleepiness score (ESS) as a screening tool for obstructive sleep apnea (OSA) severity based on the apnea-hypopnea index (AHI) and the oxygen desaturation index (ODI). Methods: Data from 235 patients who were monitored by ambulant polysomnography (PSG) were retrospectively analyzed. OSA severity was classified based on the AHI; similar classification categories were made based on the ODI. Discrimination was assessed by the area under the curve (AUC), while predictive parameters were calculated by four-grid contingency tables. Results: The NoSAS score and the STOP-Bang questionnaire were both equally adequate screening tools for the AHI and the ODI with AUC ranging from 0.695 to 0.767 and 0.684 to 0.767, respectively. Both questionnaires perform better when used as a continuous variable. The ESS did not show adequate discrimination for screening for OSA (AUC ranging from 0.450 to 0.525). Male gender, age, and BMI proved to be the strongest individual predictors in this cohort. Conclusion: This is the first study to evaluate the predictive performance of three different screening instruments with respect to both the AHI and the ODI. This is important, due to increasing evidence that the ODI may have a higher reproducibility in the clinical setting. The NoSAS score and the STOP-Bang questionnaire proved to be equally adequate to predict OSA severity based on both the AHI and the ODI.

Original languageEnglish
Pages (from-to)1267-1275
Number of pages9
JournalSleep and Breathing
Volume25
Issue number3
DOIs
Publication statusPublished - Sept 2021

Keywords

  • ESS
  • NoSAS score
  • Obstructive sleep apnea
  • Polysomnography
  • Screening
  • STOP-Bang questionnaire
  • Reproducibility of Results
  • Humans
  • Middle Aged
  • Sleep Apnea, Obstructive/diagnosis
  • Male
  • Patient Acuity
  • Adult
  • Female
  • Surveys and Questionnaires
  • Aged
  • Retrospective Studies
  • Mass Screening/instrumentation

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