Scharf S M, Garshick E, Brown R, Tishler P V, Tosteson T, McCarley R
Pulmonary Division, Brockton/West Roxbury VA Medical Center, Massachusetts.
Sleep. 1990 Aug;13(4):344-53.
We evaluated self-administered questionnaires and short sleep studies in screening for sleep-disordered breathing (SDB) in 40 hypertensive men ages 36-66 unselected for symptoms. Each subject completed a questionnaire including questions on sleep-related symptoms and underwent overnight polysomnography in which we evaluated the apnea-hypopnea index (AHI) and the percentage of time during which arterial O2 saturation was less than 90% (T90). The first 90 min of overnight study was evaluated separately, and 10 subjects with an AHI greater than or equal to 10 also underwent late afternoon nap study. By overnight polysomnography, 48% of the cohort had an AHI greater than or equal to 10, and 35% had a T90 greater than or equal to 10%. Using linear regression, we found no features of the symptom questionnaire that strongly predicted AHI. Only self-reported snoring and baseline arterial Po2 significantly predicted T90. The AHI and T90 were not significantly correlated. Considering an AHI greater than or equal to 10 in the overnight study as "abnormal" and an AHI greater than or equal to 10 on the short study as a "positive" test, the specificity of the AHI in the first 90 min was 100% (21/21), and the sensitivity was 42% (8/19). The sensitivity of the nap study was 60% (6/10). We conclude that in a cohort unselected for symptoms, the ability of self-administered questionnaires to predict SDB was low; short studies were only moderately sensitive for detecting an AHI greater than or equal to 10, and the AHI was not a major determinant of nocturnal desaturation.
我们评估了自我管理问卷和短睡眠研究在筛查40名年龄在36 - 66岁、未因症状而入选的高血压男性睡眠呼吸紊乱（SDB）中的作用。每位受试者完成了一份包括与睡眠相关症状问题的问卷，并接受了夜间多导睡眠监测，我们在监测中评估了呼吸暂停低通气指数（AHI）以及动脉血氧饱和度低于90%的时间百分比（T90）。对夜间研究的前90分钟进行了单独评估，10名AHI大于或等于10的受试者还接受了午后小睡研究。通过夜间多导睡眠监测，该队列中48%的人AHI大于或等于10，35%的人T90大于或等于10%。使用线性回归，我们发现症状问卷的特征均不能有力地预测AHI。只有自我报告的打鼾和基线动脉血氧分压能显著预测T90。AHI和T90无显著相关性。将夜间研究中AHI大于或等于10视为“异常”，短睡眠研究中AHI大于或等于10视为“阳性”测试，前90分钟AHI的特异性为100%（21/21），敏感性为42%（8/19）。小睡研究的敏感性为60%（6/10）。我们得出结论，在一个未因症状而入选的队列中，自我管理问卷预测SDB的能力较低；短睡眠研究对检测AHI大于或等于10的敏感性仅为中等，且AHI不是夜间去饱和的主要决定因素。
