Abstract
Introduction: In diagnosis of obstructive sleep apnea syndrome (OSAS) polysomnography (PSG) is a mandatory diagnostic procedure before the initiation of treatment, yet not widely accessible.
Aims: We decided to assess the predictive value (PV) of a new short tool, BOAH, and compare it with a well-known STOP-BANG Questionnaire (SBQ) in prioritizing patients with presumptive OSAS diagnosis for PSG.
Methods: We collected clinical and PSG data on 1135 patients of Sleep and Respiratory Disorders Centre. Variables of interest included elements of SBQ: snoring, tiredness, observed apneas, hypertension, body-mass index (BMI), age, neck circumference, gender. Based on PSG results we elucidated a high priority group (n=329, 36%), i.e. non-positional OSAS with apnea-hypopnea index (AHI)≥ 15/h in supine and lateral decubitus positions or overall AHI≥30/h.
Results: Elements of BOAH were associated with increased risk of clinically significant OSAS, i.e. BMI≥35 (OR 6.17, 95%CI 4.50-8,46), observed apneas (OR 2.21, 95%CI 1.56-3,14), age ≥50 (OR 1.60, 1.18-2.19) and history of hypertension (OR 2.31, 95%CI 1.26-1.70, p<0.001), but not by neck circumference, gender and the remaining aforementioned symptoms (p>0.05).
Area under the curve for BOAH was greater than for SBQ (0.76, 95%CI 0.73-0.79 vs 0.71, 95%CI 0.68-0.74, p<0.001). We used Youden index to get best cut-off values. SBQ≥6 reached sensitivity of 59%, specificity 72%, positive PV of 28% and negative PV of 76%. BOAH≥4 had sensitivity of 57%, specificity 81%, positive PV of 63% and negative PV of 77%.
Conclusion: In the presented model BOAH seems to have better predictive value than STOP-BANG in prioritizing sleep clinic patients for PSG.
- Copyright ©the authors 2016