Feketeová Eva, Mucska Imrich, Klobučníková Katarina, Grešová Soňa, Stimmelová Judita, Paraničová Ivana, Trojová Ivana, Rosenberger Jaroslav, Rimárová Kvetoslava, Dorko Erik
Department of Neurology, Faculty of Medicine, Pavol Jozef Safarik University in Kosice and Louis Pasteur University Hospital, Kosice, Slovak Republic.
Outpatient Clinic for Sleep-Disordered Breathing, University Hospital Bratislava, Bratislava, Slovak Republic.
Cent Eur J Public Health. 2018 Dec;26 Suppl:S32-S36. doi: 10.21101/cejph.a5278.
Obstructive sleep apnoea syndrome (OSAS) associated with daytime sleepiness (DS) contributes to a higher incidence of motor vehicle accidents. Validation of fitness to drive in driving license applicants, with special concern regarding OSAS accompanied by excessive DS, became mandatory under new EU legislation in January 2016. The aim of the study was to translate and validate the recommended questionnaire to screen for OSAS (Q-OSAS) in the Slovak population. No data on any Q-OSAS validation has previously been published.
The translated Q-OSAS was administered to 311 Slovak patients prior to a planned overnight polysomnography. The diagnostic accuracy of the Q-OSAS in OSAS with an apnoea-hypopnoea index of 15 or more/h of sleep was evaluated by calculating the area under the ROC curve.
The sensitivity and specificity of the cut-off at 10 points for the Q-OSAS was 57% and 67%, respectively, with an increase of sensitivity and a decrease of specificity with a lowering of the cut-off values. Excluding the Epworth Sleepiness Scale (ESS) score from the final statistics yielded the best sensitivity (77%), specificity (50%), and an area under the ROC curve (0.637) for the cut-off value of 8 points (an equivalent of 10 points with the full version of the Q-OSAS).
The Q-OSAS is an appropriate screening tool to facilitate the screening of subjects potentially at risk from moderate and severe OSAS. A modified two-step interpretation of the Q-OSAS in Slovakia yielded the best sensitivity, and in the future could promote evaluation of sleepiness in sleep and wake disorders other than OSAS for fitness to drive.
阻塞性睡眠呼吸暂停综合征（OSAS）与日间嗜睡（DS）相关，会导致机动车事故发生率升高。根据2016年1月生效的欧盟新法规，对驾驶执照申请人进行驾驶适宜性验证，尤其关注伴有过度日间嗜睡的OSAS，已成为强制性要求。本研究的目的是在斯洛伐克人群中翻译并验证用于筛查OSAS的推荐问卷（Q - OSAS）。此前尚无关于Q - OSAS验证的任何数据发表。
在计划进行的夜间多导睡眠图检查之前，将翻译后的Q - OSAS应用于311名斯洛伐克患者。通过计算ROC曲线下面积，评估Q - OSAS在呼吸暂停低通气指数为每小时睡眠15次或更多的OSAS中的诊断准确性。
Q - OSAS以10分为临界值时的敏感性和特异性分别为57%和67%，随着临界值降低，敏感性增加而特异性降低。在最终统计中排除爱泼华嗜睡量表（ESS）得分后，临界值为8分（相当于完整版本Q - OSAS的10分）时，敏感性最佳（77%），特异性为50%，ROC曲线下面积为0.637。
Q - OSAS是一种合适的筛查工具，有助于筛查可能患有中度和重度OSAS的受试者。在斯洛伐克对Q - OSAS采用改良的两步解释法可获得最佳敏感性，未来可能会促进对除OSAS之外的睡眠和觉醒障碍中的嗜睡情况进行驾驶适宜性评估。
