engleski

Detecting OSA early: the role of tiredness in screened patients

Detecting OSA early might contribute to a decreased public health economic burden. Especially when limited resources are available, low specificity might lead to unnecessary full- night recordings in healthy patients. The current study aimed to investigate predictive contribution of each item of the STOP-BANG questionnaire and pulse oximetry in OSA. Additionally, the role of older age was assessed. The study included 3128 participants admitted to Split Sleep Medicine Center, referred for polygraphy or polysomnography and assessed with STOP-BANG and Pittsburgh Sleep Quality Index (PSQI). Full-night polysomnography was conducted in-laboratory and full-night polygraphy was performed unattended. Following sleep assessment, 467 participants had no OSA and 2661 had mild to severe OSA. When only STOP-BANG variables were included in a model predicting confirmed OSA diagnosis, the largest amount of variability was explained in respondents <65 years old (R2=35, 7% ; p<0.001). All predictors were significant with the exception of tiredness. Similarly, when mean saturation was included, the variance explained was also highest in respondents <65 years old (R2=41, 9% ; p<0.001). Only tiredness and the diagnosis of hypertension were non- significant. In >65 year old respondents, lower predictive value was achieved in both models (R2=19, 9% and R2=23, 5% ; p<0.001). When AUC were calculated for correctly recognized OSA based on STOP-BANG as well as following the exclusion of item tiredness, STOP-BANG with the excluded item on tiredness performed the best. In conclusion, our findings have indicated that excluding item assessing tiredness might improve the overall predictive value of STOP-BANG. Especially in older patients, measuring mean saturation may improve OSA screening.

obstructive sleep apnea, OSA, sleep, STOP-BANG, sleep medicine

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