Huang Huai, Wang Kexin, Wu Qinhan, Li Wenjing, Jiang Hong, Liu Zilong, Wu Xiaodan, Li Shanqun
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Clinical Centre for Sleep Breathing Disorders and Snoring, Zhongshan Hospital, Fudan University, Shanghai, China.
J Thorac Dis. 2023 Jun 30;15(6):3295-3306. doi: 10.21037/jtd-22-1446. Epub 2023 Jun 15.
Limitation of daily activities and impairment of working memory have received less attention in the clinical diagnosis and prognostic assessment of obstructive sleep apnea (OSA). In this study, the Activities and Participation component of the International Classification of Functioning, Disability and Health (ICF) Sleep Disorders Brief Core Set was evaluated for its performance in predicting impaired work ability in OSA patients.
A total of 221 subjects were recruited into this cross-sectional study. ICF Sleep Disorders Brief Core Set, polysomnography, and neuropsychological tests were applied for data acquisition. Data analysis was performed by regression analysis and receiver operating characteristic (ROC) construction.
The scores for the component Activities and Participation were significantly different between the no OSA/OSA group, and were elevated as the severity of OSA increased. Scores were positively correlated with apnea-hypopnea index (AHI), trail making test (TMT), and negatively correlated with symbol digit modalities test (SDMT) correct. The component Activities and Participation performed better with the threshold of 4 in the prediction of impaired attention and work ability in severe OSA [AHI ≥30 events/h, bottom 10% of TMT part B (TMTb) scores as the diagnostic criteria], with area under the curve, sensitivity and specificity as 0.909, 71.43% and 96.72%, respectively.
The Activities and Participation component of the ICF Sleep Disorders Brief Core Set could have the potential to predict the impairment of attention and work ability in OSA patients. It provides a new perspective for the identification of OSA patients' disturbances in daily activities and improving the overall assessment level.
在阻塞性睡眠呼吸暂停（OSA）的临床诊断和预后评估中，日常活动受限和工作记忆受损较少受到关注。在本研究中，对国际功能、残疾和健康分类（ICF）睡眠障碍简要核心集的活动与参与部分进行评估，以了解其在预测OSA患者工作能力受损方面的表现。
本横断面研究共招募了221名受试者。应用ICF睡眠障碍简要核心集、多导睡眠图和神经心理学测试进行数据采集。通过回归分析和构建受试者工作特征（ROC）曲线进行数据分析。
无OSA/OSA组之间活动与参与部分的得分存在显著差异，且随着OSA严重程度的增加而升高。得分与呼吸暂停低通气指数（AHI）、连线测验（TMT）呈正相关，与符号数字模式测验（SDMT）正确得分呈负相关。在预测重度OSA（以AHI≥30次/小时、TMT B部分得分处于最低10%作为诊断标准）患者的注意力和工作能力受损方面，活动与参与部分在阈值为4时表现更佳，曲线下面积、敏感性和特异性分别为0.909、71.43%和96.72%。
ICF睡眠障碍简要核心集的活动与参与部分有可能预测OSA患者的注意力和工作能力受损情况。它为识别OSA患者日常活动中的障碍以及提高整体评估水平提供了新的视角。
