PT  - JOURNAL ARTICLE
AU  - Athanasia Pataka
AU  - Euphemia Daskalopoulou
AU  - George Kalamaras
AU  - Nikolaos Chavouzis
AU  - Katalin Fekete Passa
AU  - Paraskevi Argyropoulou
TI  - Can questionnaires improve the screening value of oximetry for assessing sleep apnea syndrome?
AID  - 10.1183/13993003.congress-2015.PA3368
DP  - 2015 Sep 01
TA  - European Respiratory Journal
PG  - PA3368
VI  - 46
IP  - suppl 59
4099  - http://erj.ersjournals.com/content/46/suppl_59/PA3368.short
4100  - http://erj.ersjournals.com/content/46/suppl_59/PA3368.full
SO  - Eur Respir J2015 Sep 01; 46
AB  - Background: Oximetry has been used as a cheap indicator of obstructive sleep apnea/hypopnea syndrome (OSAHS). Several questionnaires have been used in order to identify OSAHS.Objectives: To evaluate the clinical utility of the combination of home oximetry and 4 different questionnaires: Stop, Stop Bang(S-B), Berlin questionnaire (BQ) and Epworth Sleepiness Scale (ESS) in order to identify OSAHS compared with in-laboratory PSG.Methods: Patients visiting a Sleep Clinic were prospectively studied. They completed the questionnaires. Home oximetry and PSG were performed.Results: 204 patients participated (77.5%males, 51.8±13.8years, BMI 32.8±6.2 kg/m2). Using AHI>15 for OSAHS diagnosis, Oxygen Desaturation Index of oximetry (ODIox)≥5 had the best sensitivity(se)(99%) and negative predictive value (NPV)(97.6%), whereas ODIox≥15 had the best specificity(sp)(94%),positive predictive value (PPV)(96.5%) and area under the curve (AUC)(0.882). The predictive values of ODIox improved as the severity of OSAHS worsened (mild: se 4%, sp32.5%, severe: se97.5%, sp72.6%). S-B had the highest se(97.5%) and NPV(62.5%) but the lowest sp (9%), whereas ESS had the best sp(75%) and PPV(81.4%). The questionnaires had better predictive value than oximetry in mild OSAHS (AUC 0.18 oximetry vs. 0.51 S-B, 0.4BQ). The combination of the questionnaires with oximetry improved oximetry's sensitivity, especially in mild and moderate OSAHS, but not specificity.Conclusion: Oximetry is a useful tool for OSAHS identification especially in severe disease. Combining oximetry with questionnaires did not significantly improve the predictive value. For patients with concerns of misdiagnosis, PSG remains the test of choice.