验证 STOP、STOP-BANG、STOP-BAG、STOP-B28 和 GOAL 筛查工具在帕金森病患者中识别阻塞性睡眠呼吸暂停的准确性。
Validation of STOP, STOP-BANG, STOP-BAG, STOP-B28, and GOAL screening tools for identification of obstructive sleep apnea in patients with Parkinson disease.
机构信息
Department of Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada.
Translational Research in Respiratory Diseases, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
出版信息
J Clin Sleep Med. 2023 Jan 1;19(1):45-54. doi: 10.5664/jcsm.10262.
STUDY OBJECTIVES
Obstructive sleep apnea (OSA) is common in Parkinson disease (PD). Questionnaires can be used as screening tools and have been used as a surrogate definition of OSA in large-scale research. This study aimed to validate the performance of STOP, STOP-BANG, STOP-BAG, STOP-B28, and GOAL and OSA predictors as tools to identify OSA in PD.
METHODS
Data were analyzed from a PD cohort study in which OSA was diagnosed using laboratory polysomnography. We calculated sensitivity and specificity of each questionnaire for OSA using different definitions and performed receiver operating characteristics curve analysis. Linear regression was used to assess adjusted associations between questionnaires and outcomes: Montreal Cognitive Assessment, Epworth Sleepiness Scale, and Movement Disorder Society revision of the Unified Parkinson Disease Rating Scale.
RESULTS
Questionnaire data were available for 68 PD patients (61.8% male, mean age 64.5 [standard deviation 9.9] years, and Hoehn and Yahr score 2.1 [0.8]). OSA (apnea-hypopnea index ≥ 15 events/h) occurred in 69.4% of participants. STOP-B28 ≥ 2 presented a higher sensitivity for OSA than STOP ≥ 2 (0.76 vs 0.65, respectively) and slightly lower specificity (0.65 vs 0.70, respectively). GOAL ≥ 2 had the highest sensitivity but poor specificity. Loud snoring had sensitivity 0.63 and specificity 0.65. STOP and snoring were significantly associated with Montreal Cognitive Assessment, Epworth Sleepiness Scale, and Movement Disorder Society revision of the Unified Parkinson Disease Rating Scale (total, motor, and nonmotor); STOP-BANG, STOP-BAG, and STOP-B28 showed associations with most outcomes, but the GOAL showed none.
CONCLUSIONS
The STOP-B28 followed by STOP and presence of loud snoring alone seem to have the best overall properties to identify PD patients with OSA, whose clinical characteristics differ from the general population with OSA.
CITATION
Gomes T, Benedetti A, Lafontaine A-L, Kimoff RJ Robinson A, Kaminska M. Validation of STOP, STOP-BANG, STOP-BAG, STOP-B28, and GOAL screening tools for identification of obstructive sleep apnea in patients with Parkinson disease. . 2023;19(1):45-54.
研究目的
阻塞性睡眠呼吸暂停（OSA）在帕金森病（PD）中很常见。问卷可用作筛查工具，并已在大规模研究中用作 OSA 的替代定义。本研究旨在验证 STOP、STOP-BANG、STOP-BAG、STOP-B28 和 GOAL 以及 OSA 预测因子作为识别 PD 中 OSA 的工具的性能。
方法
对一项 PD 队列研究中的数据进行了分析，该研究使用实验室多导睡眠图诊断 OSA。我们使用不同的定义计算了每个问卷对 OSA 的敏感性和特异性，并进行了受试者工作特征曲线分析。线性回归用于评估问卷与蒙特利尔认知评估、嗜睡量表和运动障碍协会修订的统一帕金森病评定量表之间的调整关联。
结果
68 名 PD 患者（61.8%为男性，平均年龄 64.5[9.9]岁，Hoehn 和 Yahr 评分 2.1[0.8]）有问卷数据。69.4%的参与者存在 OSA（呼吸暂停-低通气指数≥15 次/小时）。STOP-B28≥2 对 OSA 的敏感性高于 STOP≥2（分别为 0.76 和 0.65），特异性略低（分别为 0.65 和 0.70）。GOAL≥2 具有最高的敏感性，但特异性差。响亮的鼾声敏感性为 0.63，特异性为 0.65。STOP 和打鼾与蒙特利尔认知评估、嗜睡量表和运动障碍协会修订的统一帕金森病评定量表（总分、运动和非运动）显著相关；STOP-BANG、STOP-BAG 和 STOP-B28 与大多数结果相关，但 GOAL 与结果均不相关。
结论
单独使用 STOP-B28 然后是 STOP 和响亮的鼾声似乎具有识别患有 OSA 的 PD 患者的最佳整体特性，其临床特征与患有 OSA 的一般人群不同。
引文
Gomes T、Benedetti A、Lafontaine A-L、Kimoff RJ Robinson A、Kaminska M. 验证 STOP、STOP-BANG、STOP-BAG、STOP-B28 和 GOAL 筛查工具用于识别帕金森病患者的阻塞性睡眠呼吸暂停。睡眠医学杂志。2023；19(1)：45-54.
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