Predicting sleep disordered breathing in outpatients with suspected OSA

Area of Science:

• Sleep Medicine
• Respiratory Medicine
• Diagnostic Tools

Background:

• Sleep disordered breathing (SDB) is a common condition requiring accurate diagnostic tools.
• Limited polygraphy is a key diagnostic method for SDB.
• Predictive questionnaires can aid in SDB assessment.

Purpose of the Study:

• To validate the predictive utility of the Berlin, STOP, and STOP-BANG questionnaires for SDB.
• To assess other patient characteristics, comorbidities, Epworth Sleepiness Scale (ESS), fractional exhaled nitric oxide (FENO), and blood markers in SDB prediction.
• To determine the effectiveness of these tools in conjunction with limited polygraphy.

Main Methods:

• A cohort of 129 patients aged ≥16 years referred to a sleep clinic for suspected obstructive sleep apnoea was studied.
• Home polygraphy was used to determine apnoea hypopnoea index (AHI) cut-points of ≥5 and ≥15/h.
• Receiver operating characteristic analysis and logistic regression were employed to analyze associations between predictive factors and SDB.

Main Results:

• STOP and STOP-BANG questionnaire scores correlated with AHI cut-points, while ESS and Berlin scores did not.
• The STOP-BANG questionnaire demonstrated a negative predictive value of 1.00 for AHI ≥15 when the score was ≥3, predicting AHI ≥5 with 79% accuracy.
• A STOP-BANG score ≥6 predicted AHI ≥15 with 72% accuracy. Neck circumference and witnessed apnoeas were independent SDB predictors.

Conclusions:

• The STOP and STOP-BANG questionnaires are valuable tools for predicting SDB within a sleep clinic setting.
• The findings suggest that modifications to the STOP-BANG questionnaire could enhance its predictive capabilities.
• Further investigation into modified STOP-BANG questionnaires is warranted for broader patient populations.