Assessment of Clinical Questionnaires for Predicting Obstructive Sleep Apnea in Patients with Non-Valvular Atrial...

Area of Science:

• Cardiology
• Sleep Medicine
• Diagnostic Accuracy Studies

Background:

• Obstructive sleep apnea (OSA) is frequently underdiagnosed in atrial fibrillation (AF) patients, particularly in low- and middle-income countries due to limited polysomnography access.
• This study focuses on Vietnamese patients with non-valvular AF, a population with specific healthcare access challenges.

Purpose of the Study:

• To evaluate the diagnostic accuracy of the STOP-BANG, Berlin, and Epworth Sleepiness Scale (ESS) questionnaires for screening OSA in Vietnamese patients with non-valvular AF.
• To identify the most practical and accurate screening tool for OSA in this specific patient demographic and healthcare context.

Main Methods:

• A cross-sectional diagnostic accuracy study involving 126 adult patients with chronic non-valvular AF in Ho Chi Minh City, Vietnam.
• Participants completed STOP-BANG, Berlin, and ESS questionnaires before undergoing unattended type III polysomnography.
• OSA was defined by an apnea-hypopnea index ≥ 5 events/hour according to ICSD-3 criteria; diagnostic performance metrics including AUC, sensitivity, and specificity were calculated.

Main Results:

• OSA prevalence was high at 74.6% among the study participants.
• The STOP-BANG questionnaire demonstrated the highest diagnostic accuracy with an AUC of 0.903, sensitivity of 81.9%, and specificity of 96.9%.
• The Berlin questionnaire showed moderate performance (AUC 0.824), while ESS performed poorly (AUC 0.499).

Conclusions:

• The STOP-BANG questionnaire exhibits superior diagnostic accuracy and practicality for screening OSA in non-valvular AF patients.
• Findings support the use of STOP-BANG for guiding referrals for sleep testing, particularly in resource-limited settings.
• This highlights the importance of OSA screening in AF management, even where diagnostic resources are constrained.