Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente Santa Clara, Santa Clara, California.
Laryngoscope. 2020 Dec;130(12):E952-E957. doi: 10.1002/lary.28592. Epub 2020 Mar 2.
OBJECTIVES/HYPOTHESIS: Otolaryngologic symptoms of obstructive sleep apnea (OSA) and their diagnostic utility are not well studied. We aimed to elucidate the prevalence of otolaryngologic symptoms among patients being evaluated for OSA. Given findings that the Reflux Symptom Index (RSI) was strongly associated with OSA status, we evaluated the diagnostic utility of the RSI for predicting OSA status.
Cross-sectional.
We recruited 101 adults presenting for ambulatory polysomnograms to the Northwestern Sleep Disorders Center from July 2017 to July 2018. The Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Leicester Cough Questionnaire (LCQ), RSI, Gastroesophageal Reflux Disease Questionnaire, Sino-Nasal Outcome Test-22, Nasal Obstruction Symptom Evaluation, Eustachian Tube Dysfunction Questionnaire 7, and Headache Impact Test were administered. Polysomnogram results were subsequently obtained. Patients with OSA (apnea-hypopnea index ≥ 5) and without OSA were compared.
Of the 101 participants, 98 had valid sleep study results. Of those, 72 were diagnosed with OSA and 26 were not. The two groups differed significantly in age and body mass index (BMI). Of the questionnaires, only the RSI and LCQ means differed significantly, with worse symptoms in the OSA group (P = .003 and .014, respectively). Upon univariate regression, age, BMI, and RSI were associated with OSA status. Using regression coefficients, a clinical score of 2 (RSI) + 1.5 (BMI) + age yielded a diagnostic model (C-statistic = 0.807, P < .001). A threshold score of 104.21 was 76.4% sensitive and 73.1% specific.
Patients with OSA have worse symptoms of laryngopharyngeal reflux as measured by the RSI. The addition of the RSI to the recognized factors of age and BMI improves diagnostic utility for OSA.
2 Laryngoscope, 2020.
目的/假设：阻塞性睡眠呼吸暂停（OSA）的耳鼻喉症状及其诊断效用尚未得到充分研究。我们旨在阐明接受 OSA 评估的患者中耳鼻喉症状的患病率。鉴于反流症状指数（RSI）与 OSA 状态密切相关的发现，我们评估了 RSI 预测 OSA 状态的诊断效用。
横断面研究。
我们招募了 101 名在 2017 年 7 月至 2018 年 7 月期间在西北睡眠障碍中心进行日间多导睡眠图检查的成年人。他们接受了 Epworth 嗜睡量表、匹兹堡睡眠质量指数、莱斯特咳嗽问卷（LCQ）、RSI、胃食管反流病问卷、Sino-Nasal Outcome Test-22、鼻阻塞症状评估、咽鼓管功能障碍问卷 7 和头痛影响测试。随后获得了多导睡眠图结果。将 OSA（呼吸暂停-低通气指数≥5）患者和非 OSA 患者进行比较。
在 101 名参与者中，有 98 名的睡眠研究结果有效。在这些人中，72 人被诊断为 OSA，26 人未被诊断为 OSA。两组在年龄和体重指数（BMI）方面存在显著差异。在这些问卷中，只有 RSI 和 LCQ 的平均值存在显著差异，OSA 组的症状更严重（分别为 P =.003 和.014）。在单变量回归中，年龄、BMI 和 RSI 与 OSA 状态相关。使用回归系数，临床评分 2（RSI）+1.5（BMI）+年龄得出一个诊断模型（C 统计量为 0.807，P <.001）。阈值评分 104.21 为 76.4%敏感和 73.1%特异。
OSA 患者的喉咽反流症状更严重，这可以通过 RSI 来衡量。将 RSI 与年龄和 BMI 等公认因素结合起来，可以提高 OSA 的诊断效用。
2 级喉镜检查，2020 年。
