Development and validation of a simple-to-use clinical nomogram for predicting obstructive sleep apnea

The high cost and low availability of polysomnography (PSG) limits the timely diagnosis of OSA. Herein, we developed and validated a simple-to-use nomogram for predicting OSA.

We collected and analyzed the cross-sectional data of 4162 participants with suspected OSA, seen at our sleep center between 2007 and 2016. Demographic, biochemical and anthropometric data, as well as sleep parameters were obtained. A least absolute shrinkage and selection operator (LASSO) regression model was used to reduce data dimensionality, select factors, and construct the nomogram. The performance of the nomogram was assessed using calibration and discrimination. Internal validation was also performed.

The LASSO regression analysis identified age, sex, body mass index, neck circumference, waist circumference, glucose, insulin, and apolipoprotein B as significant predictive factors of OSA. Our nomogram model showed good discrimination and calibration in terms of predicting OSA, and had a C-index value of 0.839 according to the internal validation. Discrimination and calibration in the validation group was also good (C-index = 0.820). The nomogram identified individuals at risk for OSA with an area under the curve (AUC) of 0.84 [95% confidence interval (CI), 0.83-0.86].

Our simple-to-use nomogram is not intended to replace standard PSG, but will help physicians better make decisions on PSG arrangement for the patients referred to sleep center.