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Predicting sleep disordered breathing in outpatients with suspected OSA.

ABSTRACT: To validate the utilities of Berlin, STOP and STOP-BANG Questionnaires, other patient characteristics, comorbidities, Epworth Sleepiness Scale (ESS), fractional exhaled nitric oxide (FENO) and blood markers for the prediction of sleep disordered breathing (SDB) on limited polygraphy.North Glasgow Sleep Service (a tertiary referral centre).129 consecutive patients, aged ?16 years, referred to the sleep clinic for assessment of possible obstructive sleep apnoea.We selected cut-points of apnoea hypopnoea index (AHI) of ?5 and ?15/h from their home polygraphy and determined associations of these with individual symptoms, questionnaire scores and other results. Receiver operating characteristic analysis and univariate and multivariate logistic regression were used to explore these.Primary: The utility of STOP, STOP-BANG and Berlin Questionnaires for prediction of SDB. Secondary: The utility of other measures for prediction of SDB.AHI was ?5 in 97 patients and ?15 in 56 patients. STOP and STOP-BANG scores were associated with both AHI cut-points but results with ESS and Berlin Questionnaire scores were negative. STOP-BANG had a negative predictive value 1.00 (0.77-1.00) for an AHI ?15 with a score ?3 predicting AHI ?5 with sensitivity 0.93 (95% CI 0.84 to 0.98) and accuracy 79%, while a score ?6 predicted AHI ?15 with specificity 0.78 (0.65 to 0.88) and accuracy 72%. Neck circumference ?17 inch and presence of witnessed apnoeas were independent predictors of SDB.STOP and STOP-BANG Questionnaires have utility for the prediction of SDB in the sleep clinic population. Modification of the STOP-BANG Questionnaire merits further study in this and other patient groups.

SUBMITTER: Cowan DC

PROVIDER: S-EPMC4010842 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Predicting sleep disordered breathing in outpatients with suspected OSA.

Cowan Douglas C DC Allardice Gwen G Macfarlane Duncan D Ramsay Darren D Ambler Heather H Banham Stephen S Livingston Eric E Carlin Christopher C

BMJ open 20140415 4

<h4>Objective</h4>To validate the utilities of Berlin, STOP and STOP-BANG Questionnaires, other patient characteristics, comorbidities, Epworth Sleepiness Scale (ESS), fractional exhaled nitric oxide (FENO) and blood markers for the prediction of sleep disordered breathing (SDB) on limited polygraphy.<h4>Setting</h4>North Glasgow Sleep Service (a tertiary referral centre).<h4>Participants</h4>129 consecutive patients, aged ≥16 years, referred to the sleep clinic for assessment of possible obstru ...[more]

PMID: 24736037

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Project description:ObjectiveTo examine the association between sleep-disordered breathing and stroke outcomes, and determine the contribution of sleep-disordered breathing to outcome disparities in Mexican Americans.MethodsIschemic stroke patients (n = 995), identified from the population-based Brain Attack Surveillance in Corpus Christi Project (2010-2015), were offered participation in a sleep-disordered breathing study including a home sleep apnea test (ApneaLink Plus). Sleep-disordered breathing (respiratory event index ≥10) was determined soon after stroke. Neurologic, functional, cognitive, and quality of life outcomes were assessed at 90 days poststroke. Regression models were used to assess associations between sleep-disordered breathing and outcomes, adjusted for sociodemographics, prestroke function and cognition, health-risk behaviors, stroke severity, and vascular risk factors.ResultsMedian age was 67 years (interquartile range [IQR] = 59-78); 62.1% were Mexican American. Median respiratory event index was 14 (IQR = 6-25); 62.8% had sleep-disordered breathing. Sleep-disordered breathing was associated with worse functional outcome (mean difference in activities of daily living/instrumental activities of daily living score = 0.15, 95% confidence interval [CI] = 0.01-0.28) and cognitive outcome (mean difference in modified Mini-Mental State Examination = -2.66, 95% CI = -4.85 to -0.47) but not neurologic or quality of life outcomes. Sleep-disordered breathing accounted for 9 to 10% of ethnic differences in functional and cognitive outcome and was associated with cognitive outcome more strongly for Mexican Americans (β = -3.97, 95% CI = -6.63 to -1.31) than non-Hispanic whites (β = -0.40, 95% CI = -4.18 to 3.39, p-interaction = 0.15).InterpretationSleep-disordered breathing is associated with worse functional and cognitive function at 90 days poststroke. These outcomes are reasonable endpoints for future trials of sleep-disordered breathing treatment in stroke. If effective, sleep-disordered breathing treatment may somewhat lessen ethnic stroke outcome disparities. ANN NEUROL 2019;86:241-250.

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Predicting sleep disordered breathing in outpatients with suspected OSA.

Publications

Predicting sleep disordered breathing in outpatients with suspected OSA.

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