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德国比较 STOP-BANG 问卷与氧减指数在筛查阻塞性睡眠呼吸暂停中的价值。

Comparison of the value of the STOP-BANG questionnaire with oxygen desaturation index in screening obstructive sleep apnea in Germany.

机构信息

Interdisciplinary Sleep Medicine Center, Charité-Universitätsmedizin Berlin, Luisenstrasse 13, 10117, Berlin, Germany.

The Federal State Autonomous Educational Institution of Higher Education, I.M Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia.

出版信息

Sleep Breath. 2023 Aug;27(4):1315-1323. doi: 10.1007/s11325-022-02727-7. Epub 2022 Oct 21.

Abstract

PURPOSE

Despite polysomnography being the gold standard method of diagnosing obstructive sleep apnea (OSA), it is time-consuming and has long waiting lists. Alternative methods including questionnaires and portable sleep devices have been developed to increase the speed of diagnosis. However, most questionnaires such as the STOP-BANG questionnaire (SBQ) are limited due to low specificity. This study evaluated the value of SBQ to screen for OSA and compared it with the oxygen desaturation index (ODI) and their combination.

METHODS

This retrospective study included patients who completed the SBQ and underwent a night at the sleep lab or home sleep testing. The ODI was extracted from these sleep study reports. The combination of SBQ with ODI and their individual scores were compared with apnea-hypopnea index (AHI) in terms of their accuracy in diagnosing OSA. Sensitivity, specificity, and area under the curve (AUC) for different severities of OSA were calculated and compared.

RESULTS

Among 132 patients, SBQ showed a sensitivity of 0.9 and a specificity of 0.3 to screen for OSA. As the severity of OSA increased, the sensitivity increased whilst specificity decreased for both measurements. ODI achieved an increased specificity of 0.8 and could correctly diagnose OSA 86% of the time which was better than SBQ's 60%. For all severities of OSA, ODI alone displayed a larger AUC than SBQ and similar AUC to their combination.

CONCLUSION

ODI produced a higher specificity and AUC than SBQ. Furthermore, ODI combined with SBQ failed to increase diagnostic value. Therefore, ODI may be the preferred way to initially screen patients for OSA as an easy-to-use alternative compared to SBQ.

摘要

目的

尽管多导睡眠图是诊断阻塞性睡眠呼吸暂停(OSA)的金标准方法,但它耗时且预约时间长。已经开发了替代方法,包括问卷和便携式睡眠设备,以提高诊断速度。然而,大多数问卷(如 STOP-BANG 问卷(SBQ))由于特异性低而受到限制。本研究评估了 SBQ 筛查 OSA 的价值,并将其与氧减指数(ODI)及其组合进行了比较。

方法

本回顾性研究纳入了完成 SBQ 并在睡眠实验室或家庭睡眠测试中过夜的患者。从这些睡眠研究报告中提取 ODI。比较 SBQ 与 ODI 及其各自的评分在诊断 OSA 方面的准确性,比较不同严重程度的 OSA 的准确性、特异性和曲线下面积(AUC)。计算并比较了不同严重程度 OSA 的敏感性、特异性和 AUC。

结果

在 132 名患者中,SBQ 筛查 OSA 的敏感性为 0.9,特异性为 0.3。随着 OSA 严重程度的增加,两种测量方法的敏感性增加,特异性降低。ODI 特异性提高到 0.8,能够正确诊断 OSA 86%的时间,优于 SBQ 的 60%。对于所有严重程度的 OSA,ODI 单独的 AUC 大于 SBQ,与两者的组合相似。

结论

ODI 的特异性和 AUC 均高于 SBQ。此外,ODI 与 SBQ 联合并未增加诊断价值。因此,与 SBQ 相比,ODI 可能是一种更简单易用的替代方法,是最初筛查 OSA 患者的首选方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6883/10427704/2038e6f77764/11325_2022_2727_Fig1_HTML.jpg

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