Hepatologist-Driven Screening for Obstructive Sleep Apnea in Patients With MASLD Using a Modified STOP-Bang...

Area of Science:

• Hepatology and Sleep Medicine
• Non-invasive Liver Disease Assessment
• Cardiorespiratory Health

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly prevalent.
• Obstructive sleep apnea (OSA) is common in MASLD patients, impacting liver disease progression.
• Effective screening strategies are needed to identify OSA in MASLD patients.

Purpose of the Study:

• To assess the feasibility of a hepatologist-led OSA screening pathway in MASLD outpatients.
• To evaluate the diagnostic yield of a modified STOP-Bang questionnaire for OSA detection.
• To examine the clinical linkage and downstream management of identified OSA cases.

Main Methods:

• A cohort of 555 MASLD outpatients were screened using the Screening for OSA in MASLD (SOMA) model.
• Referral for home sleep apnea testing (HSAT) was based on a modified STOP-Bang questionnaire, ESS, and clinical judgment.
• 258 patients with valid HSAT recordings were analyzed for OSA diagnosis (REI ≥ 15 events/hour).

Main Results:

• Clinically significant OSA (REI ≥ 15) was highly prevalent (78.7%) among HSAT-evaluated MASLD outpatients.
• The modified STOP-Bang questionnaire demonstrated better performance than the ESS in identifying OSA.
• A modified STOP-Bang score ≥ 5 offered a balanced sensitivity (59.1%) and specificity (54.5%) for significant OSA.

Conclusions:

• A hepatologist-driven OSA screening pathway using the SOMA model is feasible and identifies frequent cases of clinically significant OSA in MASLD outpatients.
• The modified STOP-Bang questionnaire shows promise as a screening tool within this integrated pathway.
• Further research is needed to confirm prevalence estimates and long-term clinical benefits.