Using anthropometric measures to screen for obstructive sleep apnea in the Sleep Heart Health Study cohort

Area of Science:

• Sleep Medicine
• Cardiorespiratory Health
• Diagnostic Screening Tools

Background:

• Obstructive sleep apnea (OSA) is a prevalent condition affecting cardiorespiratory health.
• Accurate screening tools are crucial for early diagnosis and management of moderate to severe OSA (MS-OSA).
• Existing screening methods, like the STOP-Bang Questionnaire (SBQ), have limitations.

Purpose of the Study:

• To evaluate the predictive performance of the neck circumference/height ratio (NHR) and waist circumference/height ratio (WHR) for MS-OSA.
• To compare the efficacy of NHR and WHR against the derived STOP-Bang Questionnaire (dSBQ) in predicting MS-OSA.
• To determine optimal cut points for NHR and WHR in identifying MS-OSA.

Main Methods:

• Analysis of 6,167 participants from the Sleep Heart Health Study with polysomnography and anthropometric data.
• Random division of the cohort into derivation (n=2,035) and validation (n=4,132) subsets.
• Estimation of NHR and WHR cut points in the derivation sample and evaluation of sensitivity and specificity in the validation sample.

Main Results:

• NHR and WHR showed high sensitivity (92.0% and 91.2%, respectively) for MS-OSA detection at specific cut points in the derivation sample.
• In the validation sample, areas under the receiver operator curves (aROCs) for MS-OSA were 69.8% (NHR), 65.2% (WHR), and 70.5% (dSBQ).
• No statistically significant difference was found between NHR and dSBQ aROCs (P=.997), while WHR showed a significant difference compared to dSBQ (P=.015).

Conclusions:

• The neck circumference/height ratio (NHR) is a viable screening tool for obstructive sleep apnea (OSA).
• NHR demonstrates comparable performance to the derived STOP-Bang Questionnaire (dSBQ) for MS-OSA screening.
• NHR is independent of witnessed apneas and BMI, making it applicable across various body types.