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Researchers develop new tool to screen for obstructive sleep apnea

A two-item model called No-Apnea was a “useful and practical tool” for obstructive sleep apnea screening in health care setting with limited resources to conduct a referral evaluation, according to findings recently published in the Journal of Clinical Sleep Medicine.

“The gold standard for obstructive sleep apnea (OSA) diagnosis consists of full polysomnography; however, it is not readily available for the large number of patients with suspected OSA,” Ricardo L.M. Duarte, MD, MSc, of the Sleep - Laboratório de Estudo dos Distúrbios do Sono in Brazil and colleagues wrote.

“The existing OSA screening models rely on subjective information, such as snoring, observed apnea, and choking/gasping, usually provided by the bed partner, and therefore not always available,” they added.

Researchers assigned patients to either a derivation cohort (n = 2,037) or a validation cohort (n = 2,035) from an existing database of consecutive outpatients who had been referred for polysomnography by their primary care physicians for possible sleep-disordered breathing. They also accounted for two variables in their analysis — age and neck circumference.
In the derivation cohort, the median age was 45 years and in the validation cohort, the median age was 44 years. Men in the derivation cohort had a median neck circumference of 42 cm, and women’s median neck circumference was 38 cm. These circumferences were 43 cm and 38 cm, respectively, in the validation cohort. A patient’s OSA severity was ascertained by an apnea-hypopnea index score of OSA-5, OSA-15 or OSA-30.

Duarte and colleagues found that in the derivation cohort, the area under the curve (AUC) for screening of OSA-5 was 0.784. The AUCs were 0.758 for OSA-15 and 0.754 for OSA-30. In addition, 78.1% of the OSA-5 patients, 68.8% of the OSA-15 patients and 54.4% of the OSA-30 patients were correctly screened. Results in both cohorts were similar to other tests that assess the risk for OSA such as STOP BANG or NoSAS.

A two-item model called No-Apnea was a “useful and practical tool” for obstructive sleep apnea screening in health care setting with limited resources to conduct a referral evaluation. according to findings recently published in the Journal of Clinical Sleep Medicine.

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“This tool should enable allocation of patients to different severity types and corresponding priorities, and thus enable improved patient prioritization and resource allocation,” Duarte and colleagues wrote.

“No-Apnea ... contains only two objective variables easily obtained during the evaluation of a patient with suspected [obstructive sleep apnea]. Therefore, it can also be used in individuals who sleep alone, in whom subjective information about sleep is not necessarily available,” they added. – by Janel Miller