Ogunyemi Lanre, Nafisa Syeda, Stacey Tanya, Sovani Milind
Department of Occupational Medicine, Trinity Occupational and Public Health Solutions, Nottingham, United Kingdom.
Department of Respiratory Medicine, Nottingham University Hospitals, Nottingham, United Kingdom.
Lung India. 2023 Mar-Apr;40(2):102-106. doi: 10.4103/lungindia.lungindia_337_22.
Obstructive sleep apnoea (OSA) in drivers/workers has been implicated in railway and road traffic safety incidents; however, there are insufficient data on its prevalence and cost-effective screening methods.
This pragmatic study examines four OSA screening tools: the Epworth sleepiness scale (ESS), the STOP-Bang (SB), the adjusted neck circumference (ANC) and the body mass index (BMI), exploring their suitability and effectiveness separately and in combination.
Using all four tools, 292 train drivers were opportunistically screened between 2016 and 2017. A polygraph (PG) test was carried out when OSA was suspected. Patients with an apnoea-hypopnea index (AHI) ≥5 were referred to a clinical specialist and reviewed annually. Those who had continuous positive airway pressure (CPAP) treatment were evaluated for compliance and control.
Of the 40 patients who had PG testing, 3 and 23 participants met the ESS >10 and SB >4, criteria, respectively, whereas 25 participants each had an ANC >48 and a BMI >35 with a risk factor or ≥40 with none. OSA was detected in 3, 18 and 16 of them who met the ESS, SB and ANC criteria, respectively, and was positive for OSA in addition to 16 others who met the BMI criteria. A total of 28 (72%) were diagnosed with OSA.
Although when used individually, these screening methods are less effective/inadequate, combining them is easy, feasible and offers the maximum chance of OSA detection in train drivers.
司机/工人的阻塞性睡眠呼吸暂停（OSA）与铁路和道路交通安全事故有关；然而，关于其患病率和具有成本效益的筛查方法的数据不足。
这项实用性研究考察了四种OSA筛查工具：爱泼沃斯嗜睡量表（ESS）、STOP-Bang问卷（SB）、校正颈围（ANC）和体重指数（BMI），分别探讨它们单独使用和联合使用时的适用性和有效性。
在2016年至2017年期间，使用这四种工具对292名火车司机进行了机会性筛查。当怀疑有OSA时，进行多导睡眠图（PG）测试。呼吸暂停低通气指数（AHI）≥5的患者被转诊给临床专家，并每年进行复查。对接受持续气道正压通气（CPAP）治疗的患者进行依从性和控制情况评估。
在接受PG测试的40名患者中，分别有3名和23名参与者符合ESS>10和SB>4的标准，而25名参与者的ANC>48且BMI>35有危险因素，或BMI≥40无危险因素。分别有3名、18名和16名符合ESS、SB和ANC标准的患者被检测出患有OSA，另外有16名符合BMI标准的患者OSA检测呈阳性。共有28名（72%）被诊断为OSA。
虽然这些筛查方法单独使用时效果较差/不够充分，但将它们结合起来简单、可行，并且在火车司机中提供了检测OSA的最大机会。
