Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota.
Department of Neurology, Mayo Clinic, Rochester, Minnesota.
J Clin Sleep Med. 2017 Sep 15;13(9):1067-1074. doi: 10.5664/jcsm.6724.
To validate the previously published National Healthy Sleep Awareness Project (NHSAP) Surveillance and Epidemiology Workgroup questionnaire for ability to determine risk for moderate to severe obstructive sleep apnea (OSA).
The NHSAP sleep questions, part of the next Behavioral Risk Factor Surveillance System (BRFSS), were constructed to mimic elements of the STOP sleep apnea questionnaire, and included number of days with sleep disruption and unintentional dozing and a history of snoring and apneas. The responses to four sleep questions from the BRFSS were collected from 352 adults undergoing in-laboratory polysomnography at Mayo Clinic, Rochester, Minnesota. Demographic and clinical information, including sex, age, body mass index (BMI), and presence of hypertension, which will be available in other parts of the complete BRFSS, were obtained by chart review. Univariate and logistic regression analyses were performed, and values of < .05 were considered to be statistically significant.
Fifty-five percent of subjects were men and 45% were women with a median age of 58 years and BMI 32.2 kg/m. Sixty percent had no or mild OSA, and 40% had moderate to severe OSA. No single question was superior in screening for moderate to severe OSA, although a history of snoring and witnessed apneas was more likely to predict moderate to severe OSA. Male sex, age ≥ 50 years, BMI ≥ 30 kg/m, presence of hypertension, and a history of snoring and witnessed apneas were the most highly weighted factors in predicting moderate to severe OSA. When each variable was dichotomized to a single point, a cutoff of 5 points significantly predicted a high risk of moderate to severe OSA with an odds ratio of 3.87 (2.39-6.27).
Although many variables were positively associated with the apnea-hypopnea index, no single factor was superior in predicting moderate to severe OSA. Male sex, increased age, higher BMI, hypertension, and a history of snoring and witnessed apneas are the most highly predictive of moderate to severe OSA. Combined use of the NHSAP questionnaire and demographic and clinical characteristics could be considered for screening for moderate to severe OSA.
验证先前发表的全国健康睡眠意识项目（NHSAP）监测和流行病学工作组问卷，以确定中重度阻塞性睡眠呼吸暂停（OSA）的风险。
NHSAP 睡眠问题是下一个行为风险因素监测系统（BRFSS）的一部分，旨在模仿 STOP 睡眠呼吸暂停问卷的元素，包括睡眠中断和非自愿打盹的天数以及打鼾和呼吸暂停的病史。从明尼苏达州罗切斯特市梅奥诊所接受实验室多导睡眠图检查的 352 名成年人中收集了 BRFSS 的四个睡眠问题的回答。通过病历回顾获得人口统计学和临床信息，包括性别、年龄、体重指数（BMI）和高血压的存在，这些信息将在完整 BRFSS 的其他部分提供。进行了单变量和逻辑回归分析，认为 <.05 有统计学意义。
55%的受试者为男性，45%为女性，中位年龄为 58 岁，BMI 为 32.2kg/m。60%的人没有或轻度 OSA，40%的人有中重度 OSA。虽然打鼾和目击呼吸暂停的病史更有可能预测中重度 OSA，但没有一个单一的问题在筛查中重度 OSA 方面更具优势。男性、年龄≥50 岁、BMI≥30kg/m、高血压以及打鼾和目击呼吸暂停的病史是预测中重度 OSA 的最重要因素。当每个变量都被二分类为一个点时，5 分的截点显著预测了中重度 OSA 的高风险，其优势比为 3.87（2.39-6.27）。
尽管许多变量与呼吸暂停低通气指数呈正相关，但没有一个单一的因素在预测中重度 OSA 方面更具优势。男性、年龄增长、BMI 升高、高血压以及打鼾和目击呼吸暂停的病史是预测中重度 OSA 的最重要因素。NHSAP 问卷和人口统计学及临床特征的联合使用可考虑用于筛查中重度 OSA。
