Cardiology Department, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre (RS), Brazil.
School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre (RS), Brazil.
J Clin Sleep Med. 2024 Jun 1;20(6):879-885. doi: 10.5664/jcsm.11022.
Four well-established predictors of obstructive sleep apnea (OSA) risk are body mass index, age, sex, and neck circumference. We have previously reported cheeks appearance as an OSA predictor, which may represent a combination of such predictors in a single, readily available feature. This study sought to answer the question: Is cheeks appearance an OSA risk predictor?
This was a prospective cross-sectional diagnostic accuracy study based on STARD (standards for reporting diagnostic accuracy studies). Patients undergoing polysomnography to investigate sleep complaints at a sleep clinic affiliated with a university hospital were assessed using cheeks appearance scored 0-3 for volume and 0-3 for flaccidity to create the Cheeks Appearance for Sleep Apnea (CASA) score ranging from 0 to 6. Appearance was judged by 3 blinded and independent evaluators.
Among 265 patients evaluated, 248 were included. Fifty-seven patients had a CASA score of 0 and 191 had a CASA score between 1 and 6. Polysomnography diagnosed 177 of the individuals with OSA; of these, 167 had an altered CASA score. Sensitivity was 87%, specificity was 82%, positive-predictive value was 94%, negative-predictive value was 66%, and accuracy was 86%.
Our results suggest that combining volume and flaccidity of cheeks appearance in a single index may constitute a reliable OSA predictor. CASA score is a novel predictor of OSA with internal validity in a sleep laboratory adult population. Our findings support further studies to confirm the external validity of this practical diagnostic tool.
Registry: ClinicalTrials.gov; Name: Cheeks Appearance as a Novel Predictor of Obstructive Sleep Apnea: The CASA Score Study (CASA); URL: https://clinicaltrials.gov/study/NCT04980586; Identifier: NCT04980586.
Prikladnicki A, Gomes E, Sousa LCCR, Gonçalves SC, Martinez D. Cheeks appearance as a novel predictor of obstructive sleep apnea: the CASA score study. . 2024;20(6):879-885.
阻塞性睡眠呼吸暂停（OSA）风险的四个公认预测因素是体重指数、年龄、性别和颈围。我们之前曾报道过脸颊外观是 OSA 的预测因素，这可能代表了单一、易于获得的特征中这些预测因素的组合。本研究旨在回答以下问题：脸颊外观是否是 OSA 的风险预测因素？
这是一项基于 STARD（诊断准确性研究报告标准）的前瞻性横断面诊断准确性研究。在一家大学附属医院的睡眠诊所进行多导睡眠图检查以调查睡眠投诉的患者，使用脸颊外观评分 0-3 分评估体积和 0-3 分评估松弛度，以创建 CASA 评分（范围 0-6 分）。外观由 3 名盲法和独立评估者判断。
在评估的 265 名患者中，248 名患者纳入研究。57 名患者的 CASA 评分为 0，191 名患者的 CASA 评分为 1-6。多导睡眠图诊断出 177 名患者患有 OSA；其中 167 名患者的 CASA 评分发生改变。敏感性为 87%，特异性为 82%，阳性预测值为 94%，阴性预测值为 66%，准确性为 86%。
我们的结果表明，将脸颊外观的体积和松弛度结合在一个单一的指数中可能构成一个可靠的 OSA 预测因素。CASA 评分是一种新的 OSA 预测指标，在睡眠实验室成人人群中具有内部有效性。我们的研究结果支持进一步研究以确认这种实用诊断工具的外部有效性。
注册处：ClinicalTrials.gov；名称：脸颊外观作为阻塞性睡眠呼吸暂停的新型预测指标：CASA 评分研究（CASA）；网址：https://clinicaltrials.gov/study/NCT04980586；标识符：NCT04980586。
Prikladnicki A, Gomes E, Sousa LCCR, Gonçalves SC, Martinez D. Cheeks appearance as a novel predictor of obstructive sleep apnea: the CASA score study.. 2024;20(6):879-885.
