Eijsvogel Michiel M, Wiegersma Sytske, Randerath Winfried, Verbraecken Johan, Wegter-Hilbers Esther, van der Palen Job
Department of Pulmonology and Sleep Medicine, Medisch Spectrum Twente Hospital, Enschede, The Netherlands.
MIRA-Institute for Biomedical Technology & Technical Medicine, University of Twente, Enschede, The Netherlands.
J Clin Sleep Med. 2016 Apr 15;12(4):555-64. doi: 10.5664/jcsm.5690.
To develop and evaluate a screening questionnaire and a two-step screening strategy for obstructive sleep apnea syndrome (OSAS) in healthy workers.
This is a cross-sectional study of 1,861 employees comprising healthy blue- and white-collar workers in two representative plants in the Netherlands from a worldwide consumer electronic company who were approached to participate. Employees were invited to complete various sleep questionnaires, and undergo separate single nasal flow recording and home polysomnography on two separate nights.
Of the 1,861 employees, 249 provided informed consent and all nasal flow and polysomnography data were available from 176 (70.7%). OSAS was diagnosed in 65 (36.9%). A combination of age, absence of insomnia, witnessed breathing stops, and three-way scoring of the Berlin and STOPBANG questionnaires best predicted OSAS. Factor analysis identified a six-factor structure of the resulting new questionnaire: snoring, snoring severity, tiredness, witnessed apneas, sleep quality, and daytime well-being. Subsequently, some questions were removed, and the remaining questions were used to construct a new questionnaire. A scoring algorithm, computing individual probabilities of OSAS as high, intermediate, or low risk, was developed. Subsequently, the intermediate risk group was split into low and high probability for OSAS, based on nasal flow recording. This two-step approach showed a sensitivity of 63.1%, and a specificity of 90.1%. Specificity is important for low prevalence populations.
A two-step screening strategy with a new questionnaire and subsequent nasal flow recording is a promising way to screen for OSAS in a healthy worker population.
Development and validation of a screening instrument for obstructive sleep apnea syndrome in healthy workers. Netherlands Trial Register (www.trailregister.nl), number: NTR2675.
开发并评估针对健康工作者阻塞性睡眠呼吸暂停综合征（OSAS）的筛查问卷及两步筛查策略。
这是一项横断面研究，纳入了来自一家全球消费电子公司位于荷兰的两家代表性工厂的1861名员工，包括健康的蓝领和白领工人，邀请他们参与研究。员工被邀请完成各种睡眠问卷，并在两个不同的夜晚分别进行单次鼻气流记录和家庭多导睡眠图检查。
1861名员工中，249人提供了知情同意，176人（70.7%）的所有鼻气流和多导睡眠图数据可用。65人（36.9%）被诊断为OSAS。年龄、无失眠、目睹呼吸暂停以及柏林问卷和STOPBANG问卷的三分法评分相结合，对OSAS的预测效果最佳。因子分析确定了新问卷的六因子结构：打鼾、打鼾严重程度、疲劳、目睹呼吸暂停、睡眠质量和日间幸福感。随后，删除了一些问题，其余问题用于构建新问卷。开发了一种评分算法，计算OSAS的高、中、低风险个体概率。随后，根据鼻气流记录将中度风险组分为OSAS的低概率和高概率组。这种两步法的敏感性为63.1%，特异性为90.1%。特异性对于低患病率人群很重要。
采用新问卷及随后的鼻气流记录的两步筛查策略，是在健康工作人群中筛查OSAS的一种有前景的方法。
健康工作者阻塞性睡眠呼吸暂停综合征筛查工具的开发与验证。荷兰试验注册中心（www.trailregister.nl），编号：NTR2675。
