Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland.
Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland.
Sci Rep. 2019 Apr 30;9(1):6676. doi: 10.1038/s41598-019-43199-2.
Polysomnography (PSG) is considered the gold standard in obstructive sleep apnea-hypopnea syndrome (OSAS) diagnostics, but its availability is still limited. Thus, it seems useful to assess patients pre-diagnostic risk for OSAS to prioritize the use of this examination. The purpose of this study was to assess positive (PPV) and negative (NPV) predictive values of the STOP BANG questionnaire (SBQ) in patients with presumptive diagnosis of OSAS. From a database of 1,171 (880 men) patients of a university based sleep center, 1,123 (847 men) met eligibility criteria and their SBQ scores were subject to the Bayesian analysis. The analysis of PPV and NPV was conducted at all values of SBQ for all subjects, but also separately for males and females, and for total sleep time (TS) and for sleep in the lateral position (LP). The probability of OSAS (AHI ≥ 5) and at least moderate OSAS (AHI ≥ 15) for TS was 0.766 and 0.516, while for LP the values were 0.432 and 0.289, respectively. Overall, due to low specificity, SBQ had low PPV for TS and LP. Negative test result (SBQ < 3) revealed NPV of 0.620 at AHI < 5 and 0.859 at AHI < 15 for TS, while in LP NPV values were 0.935 at AHI < 5 and 1.0 at AHI < 15, (n = 31), while SBQ < 4 generated NPV of 0.943 in LP (n = 105). SBQ did not change probabilities of OSAS to confirm or rebut diagnosis for TS. However, it is highly probable that SQB can rule out OSAS diagnosis at AHI ≥ 15 for LP.
多导睡眠图（PSG）被认为是阻塞性睡眠呼吸暂停低通气综合征（OSAS）诊断的金标准，但它的可用性仍然有限。因此，评估患者 OSAS 的预诊断风险以优先使用该检查似乎是有用的。本研究旨在评估阻塞性睡眠呼吸暂停低通气综合征（OSAS）可疑患者中 STOP BANG 问卷（SBQ）的阳性（PPV）和阴性（NPV）预测值。从一个大学睡眠中心的 1171 名（880 名男性）患者的数据库中，有 1123 名（847 名男性）符合入选标准，他们的 SBQ 评分进行了贝叶斯分析。在所有 SBQ 值下对所有受试者进行了 PPV 和 NPV 的分析，但也分别对男性和女性以及总睡眠时间（TS）和侧卧位（LP）进行了分析。对于 TS，OSAS（AHI≥5）和至少中度 OSAS（AHI≥15）的概率分别为 0.766 和 0.516，而对于 LP，相应的概率分别为 0.432 和 0.289。总体而言，由于特异性低，SBQ 对 TS 和 LP 的 PPV 较低。对于 SBQ<3 的阴性检测结果，AHI<5 时的 NPV 为 0.620，AHI<15 时的 NPV 为 0.859，对于 LP，NPV 值分别为 AHI<5 时的 0.935 和 AHI<15 时的 1.0，（n=31），而 SBQ<4 时在 LP 中产生的 NPV 为 0.943（n=105）。SBQ 并未改变 OSAS 诊断的可能性，以确认或反驳 TS 的诊断。然而，对于 LP，SBQ 极有可能排除 AHI≥15 的 OSAS 诊断。
