Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
Sleep Breath. 2023 Jun;27(3):913-921. doi: 10.1007/s11325-022-02642-x. Epub 2022 Jul 27.
Diagnosis of obstructive sleep apnea requires polysomnography which has limited availability. We aimed to develop and validate a risk score in predicting clinically significant OSA among the Thai population.
We reviewed polysomnographic studies performed in adults diagnosed with OSA in King Chulalongkorn Memorial Hospital from 2017 to 2019. 1798 and 450 patients were randomly enrolled in development and validation cohorts, respectively. A risk score was developed using multiple factor analysis and logistic regression. The NH-OSA score was externally validated at the Bangkok Christian Hospital. We compared its performance to existing screening scores (STOP-BANG, Berlin Questionnaire, Epworth Sleepiness Scale (ESS), and NoSAS score).
The NH-OSA score allocates 1 point for having neck circumference ≥ 13 inches (in women) or 15 inches (in men), 4 points for the presence of hypertension, 3 or 5 or 7 points for having a body mass index of 23-24.9, 25-30, ≥ 30 kg/m, respectively, 9 points for the presence of moderate or severe snoring, and 5 points for age ≥ 40 years. With a cutoff value at 14 points, the sensitivity and specificity were 82.1% and 68.7%, respectively. The AUC was 0.75 (0.73-0.78). Both internal and external validation study revealed high AUC of 0.74 (0.68-0.80) and 0.75 (0.60-0.90), respectively. These were greater when compared to STOP-BANG, Berlin Questionnaire, ESS, and NoSAS score.
NH-OSA is a newly developed tool which has good performance in predicting clinically significant OSA with high validity among the Thai population. It could help screen patients at risk of OSA for further investigation.
阻塞性睡眠呼吸暂停的诊断需要进行多导睡眠图检查，但该检查的可及性有限。本研究旨在开发和验证一种适用于泰国人群的预测临床显著阻塞性睡眠呼吸暂停风险的评分系统。
我们回顾了 2017 年至 2019 年在泰国朱拉隆功国王纪念医院进行的成人阻塞性睡眠呼吸暂停多导睡眠图检查的研究。其中 1798 例和 450 例患者分别被随机纳入开发队列和验证队列。使用多因素分析和逻辑回归方法建立风险评分。NH-OSA 评分在曼谷基督教医院进行了外部验证。我们将其与现有的筛查评分（STOP-BANG 评分、柏林问卷、Epworth 嗜睡量表和 NoSAS 评分）进行了比较。
NH-OSA 评分系统为以下情况分别计 1 分：颈围 ≥ 13 英寸（女性）或 15 英寸（男性）；存在高血压；体质指数为 23-24.9、25-30 和 ≥ 30 kg/m2 时分别计 3、5 或 7 分；存在中重度打鼾；年龄 ≥ 40 岁时计 5 分。截断值为 14 分，其敏感性和特异性分别为 82.1%和 68.7%。AUC 为 0.75（0.73-0.78）。内部和外部验证研究均显示出较高的 AUC（分别为 0.74 [0.68-0.80] 和 0.75 [0.60-0.90]）。与 STOP-BANG 评分、柏林问卷、Epworth 嗜睡量表和 NoSAS 评分相比，这些评分都更高。
NH-OSA 是一种新开发的工具，在预测泰国人群中具有临床意义的阻塞性睡眠呼吸暂停方面具有良好的性能，且具有较高的有效性。它可以帮助筛选出有阻塞性睡眠呼吸暂停风险的患者，以便进一步检查。
