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[Effect of HCO

S Zhang1, S M Qing, H Liu

  • 1State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.

Zhonghua Yi Xue Za Zhi
|September 18, 2018
PubMed
Summary

Adding arterial blood bicarbonate levels to the NoSAS questionnaire improves obstructive sleep apnea hypopnea syndrome screening specificity but reduces sensitivity. This combination enhances diagnostic accuracy for OSAHS.

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Area of Science:

  • Respiratory Medicine
  • Sleep Medicine
  • Clinical Diagnostics

Background:

  • Obstructive sleep apnea hypopnea syndrome (OSAHS) is a prevalent sleep disorder.
  • The NoSAS questionnaire is a screening tool for OSAHS, but its accuracy can be limited.
  • Arterial blood bicarbonate (HCO3-) levels may influence OSAHS diagnosis.

Purpose of the Study:

  • To assess the impact of arterial blood HCO3- levels on the accuracy of the NoSAS questionnaire for OSAHS screening.
  • To evaluate the correlation between HCO3- levels and the apnea-hypopnea index (AHI).

Main Methods:

  • Hospitalized patients with suspected OSAHS underwent NoSAS scoring, arterial blood gas analysis, and polysomnography (PSG).
  • Patients were categorized into non-OSAHS, mild, moderate, and severe OSAHS groups based on PSG results.
Keywords:
BicarbonatesBlood gas analysisNoSAS questionnaireScreeningSleep apnea, obstructive

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  • Receiver operating characteristic (ROC) curve analysis was used to determine the predictive accuracy of HCO3- levels and NoSAS scores.

    • Main Results:

    • Arterial blood HCO3- levels showed a positive correlation with AHI (r=0.206, P=0.001).
    • Higher HCO3- levels (≥26 mmol/L) were more prevalent in OSAHS patients compared to non-OSAHS patients (34.5% vs 13.0%, P=0.004).
    • Combining HCO3- level ≥26 mmol/L with a NoSAS score ≥7 significantly increased specificity (93.6%) but decreased sensitivity (27.4%) for OSAHS detection.

    Conclusions:

    • Arterial blood HCO3- levels can improve the specificity of the NoSAS questionnaire in screening for OSAHS.
    • While enhancing specificity, the addition of HCO3- levels to the NoSAS score leads to a reduction in sensitivity.
    • This study suggests that incorporating HCO3- levels may refine OSAHS screening, particularly for increasing diagnostic certainty.