Maislin G, Pack A I, Kribbs N B, Smith P L, Schwartz A R, Kline L R, Schwab R J, Dinges D F
Center for Sleep and Respiratory Neurobiology, University of Pennsylvania School of Medicine, Philadelphia 19104-4283, USA.
Sleep. 1995 Apr;18(3):158-66. doi: 10.1093/sleep/18.3.158.
Questionnaire data from patients presenting at three sleep disorders centers were used to develop and assess a screening tool for sleep apnea based on the reporting of the frequency of various symptoms of sleep apnea and other sleep disorders plus age, body mass index (BMI) and gender. Patients were not specifically referred for suspicion of sleep apnea. Separate factor analyses of survey responses from 658, 193 and 77 respondents from the first, second and third sites, respectively, each yielded four orthogonal factors, one of which accounted for all the questions concerned with the frequency of disordered breathing during sleep. The survey was shown to be reliable in a subset of patients from one of the sites (test-retest correlation = 0.92). Survey data were then compared to a clinical measure of sleep apnea (respiratory disturbance index) obtained from polysomnography. A multivariable apnea risk index including survey responses, age, gender and BMI was estimated using multiple logistic regression in a total sample of 427 respondents from two of the sites. Predictive ability was assessed using receiver operating characteristic (ROC) curves. The area under the ROC curve was 0.79 (p < 0.0001). For BMI alone, it was 0.73, and for an index measuring the self-report of the frequency of apnea symptoms, it was 0.70. The multivariable apnea risk index has potential utility in clinical settings.
来自三个睡眠障碍中心的患者问卷数据被用于开发和评估一种基于睡眠呼吸暂停及其他睡眠障碍各种症状出现频率报告、年龄、体重指数（BMI）和性别的睡眠呼吸暂停筛查工具。患者并非因怀疑睡眠呼吸暂停而被特意转诊。分别对来自第一、第二和第三站点的658名、193名和77名受访者的调查回复进行因子分析，每个站点均得出四个正交因子，其中一个因子涵盖了所有与睡眠期间呼吸紊乱频率相关的问题。在其中一个站点的部分患者中，该调查显示出可靠性（重测相关性 = 0.92）。然后将调查数据与通过多导睡眠图获得的睡眠呼吸暂停临床指标（呼吸紊乱指数）进行比较。在来自两个站点的427名受访者的总样本中，使用多元逻辑回归估计了一个包括调查回复、年龄、性别和BMI的多变量呼吸暂停风险指数。使用受试者工作特征（ROC）曲线评估预测能力。ROC曲线下面积为0.79（p < 0.0001）。仅BMI的曲线下面积为0.73，用于测量呼吸暂停症状出现频率自我报告的指数的曲线下面积为0.70。该多变量呼吸暂停风险指数在临床环境中具有潜在用途。
