DoISnorePreg questionnaire helps diagnose OSA in high-risk pregnancy
Click Here to Manage Email Alerts
Key takeaways:
- Underdiagnosed OSA can lead to pregnancy complications.
- This survey, designed for high-risk pregnancies, was more effective in predicting OSA compared with other questionnaires.
HONOLULU — A new questionnaire, developed to predict obstructive sleep apnea in high-risk pregnancy, outperformed other diagnostic tools, according to a study presented at the CHEST Annual Meeting.
“Underdiagnosed OSA can lead to a lot of complications, especially specifically in pregnancy, like preeclampsia, gestational diabetes and preterm delivery,” Kristin N. Sheehan, MD, pulmonary and critical care medicine fellow at Wake Forest University School of Medicine, told Healio. “We chose a high-risk obstetric population which is really underrepresented in the literature, and the current sleep questionnaires that we have to assess the OSA risk in these patients are pretty poor predictors. So, we built a new questionnaire, the DoISnorePreg and assessed its ability to predict OSA comparing it to polysomnography and found that it actually performed very well, especially compared to other questionnaires.”
Derived from the DOISNORE50 sleep questionnaire, the DoISnorePreg includes additional questions associated with high-risk obstetric patients.
The prospective cohort study included 100 patients from a single high-risk obstetric clinic who did not have any previous OSA diagnoses. Each patient filled out the DoISnorePreg, the Epworth Sleepiness Scale and Berlin Questionnaire. Patients also completed an at-home polysomnogram after 28 weeks’ gestation.
“The study was powered to detect the difference in endothelin levels during an OSA prevalence of 15%,” Sheehan said during her presentation.
Patients were stratified based on apnea-hypopnea index (AHI) score, with those with AHI scores greater than 5 being diagnostic for OSA.
Of the 98 patients who completed the sleep study, 38 were found to have OSA, with 11 being moderate or severe.
Patients with OSA had both a higher mean BMI at the time of the sleep study (47.07 kg/m2 vs. 42.62 kg/m2; P = .033) and at delivery (48.02 kg/m2 vs. 43.36 kg/m2; P = .021) and older mean maternal age (33.74 years vs. 30.53 years; P = .007) than the rest of the cohort.
The DoISnorePreg questionnaire outperformed the other questionnaires with receiver operating characteristic analytics showing an area under the curve of 0.74, compared with 0.58 for the Berlin Questionnaire and 0.5 for the Epworth Sleepiness Scale.
Also, based on a threshold of at least four positive responses, the DoISnorePreg predicted OSA with a sensitivity of 89% and specificity of 43% (P < .01).
“The DoISnorePreg questionnaire helps fill a gap where prior questionnaires have variable results,” Sheehan said. “The results of this prospective trial of a self-administered DoISnorePreg questionnaire helps support its use in screening patients for OSA in a high-risk obstetric population. It helps enhance provider ability to both identify and treat OSA in this population.”