Combination of oximetry and sleep questionnaires as screening tools for CPAP initiation in patients with obstructive sleep apnea

Objectives Obstructive sleep apnea syndrome (OSA) is a cause of high morbidity and mortality so diagnosis and treatment is essential. Questionnaires and oximetry have been used for OSA screening.Aim To evaluate the clinical utility of different sleep questionnaires (Stop Bang (S-B), Berlin (BQ), Epw...

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Main Authors: A. Pataka, G. Kalamaras, E. Vlachogianni, P. Argyropoulou
Format: Article
Language:English
Published: Taylor & Francis 2019-05-01
Series:Pulmonology
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Online Access:https://www.tandfonline.com/doi/10.1016/j.pulmoe.2018.10.004
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author A. Pataka
G. Kalamaras
E. Vlachogianni
P. Argyropoulou
author_facet A. Pataka
G. Kalamaras
E. Vlachogianni
P. Argyropoulou
author_sort A. Pataka
collection DOAJ
description Objectives Obstructive sleep apnea syndrome (OSA) is a cause of high morbidity and mortality so diagnosis and treatment is essential. Questionnaires and oximetry have been used for OSA screening.Aim To evaluate the clinical utility of different sleep questionnaires (Stop Bang (S-B), Berlin (BQ), Epworth Sleepiness Scale (ESS)) in deciding on treatment with Continuous Positive Airway Pressure (CPAP) and to examine whether the combination of the questionnaires alone or with oximetry improves their predictive value for CPAP initiation.Methods Patients visiting a Sleep Clinic were prospectively studied. They completed the questionnaires. Home oximetry and in laboratory polysomnography (PSG) were performed within 3–20 days. Patients received CPAP if they were symptomatic with AHI ≥ 5 or had AHI > 15.Results 204 patients were studied (77.5%males, mean age 51.8 ± 13.8 years, BMI 32.8 ± 6.2 kg/m2). There was a good correlation between Oxygen Desaturation Index of oximetry (ODIox) and ODI of PSG (r = 0.95, p < 0.0001) and between ODIox and AHI (r = 0.811, p < 0.0001). ODIox ≥ 15 presented sensitivity 89.3%, specificity 83.5%, PPV 87% NPV 86.4% for CPAP initiation. ESS had the best specificity (68.6%) and PPV (68.6%) and S-B had the highest sensitivity (98%) and NPV (80%) but the lowest specificity (11%) for CPAP initiation. The combination of different questionnaires or questionnaires with oximetry did not improve their predictive value for CPAP initiation.Conclusions Oximetry accurately predicted CPAP initiation. Questionnaires alone had limited value as screening tools for CPAP initiation; the combination of oximetry with questionnaires did not improve their predictive value.
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spelling doaj-art-5f48a0bfc47c4e81812bc7aef71d011f2025-08-20T03:48:01ZengTaylor & FrancisPulmonology2531-04292531-04372019-05-0125313714210.1016/j.pulmoe.2018.10.004Combination of oximetry and sleep questionnaires as screening tools for CPAP initiation in patients with obstructive sleep apneaA. Pataka0G. Kalamaras1E. Vlachogianni2P. Argyropoulou3Respiratory Failure Unit, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, GreeceRespiratory Failure Unit, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, GreeceSleep Laboratory, Department of Internal Medicine, “St. Paul” General Hospital, Thessaloniki, GreeceRespiratory Failure Unit, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, GreeceObjectives Obstructive sleep apnea syndrome (OSA) is a cause of high morbidity and mortality so diagnosis and treatment is essential. Questionnaires and oximetry have been used for OSA screening.Aim To evaluate the clinical utility of different sleep questionnaires (Stop Bang (S-B), Berlin (BQ), Epworth Sleepiness Scale (ESS)) in deciding on treatment with Continuous Positive Airway Pressure (CPAP) and to examine whether the combination of the questionnaires alone or with oximetry improves their predictive value for CPAP initiation.Methods Patients visiting a Sleep Clinic were prospectively studied. They completed the questionnaires. Home oximetry and in laboratory polysomnography (PSG) were performed within 3–20 days. Patients received CPAP if they were symptomatic with AHI ≥ 5 or had AHI > 15.Results 204 patients were studied (77.5%males, mean age 51.8 ± 13.8 years, BMI 32.8 ± 6.2 kg/m2). There was a good correlation between Oxygen Desaturation Index of oximetry (ODIox) and ODI of PSG (r = 0.95, p < 0.0001) and between ODIox and AHI (r = 0.811, p < 0.0001). ODIox ≥ 15 presented sensitivity 89.3%, specificity 83.5%, PPV 87% NPV 86.4% for CPAP initiation. ESS had the best specificity (68.6%) and PPV (68.6%) and S-B had the highest sensitivity (98%) and NPV (80%) but the lowest specificity (11%) for CPAP initiation. The combination of different questionnaires or questionnaires with oximetry did not improve their predictive value for CPAP initiation.Conclusions Oximetry accurately predicted CPAP initiation. Questionnaires alone had limited value as screening tools for CPAP initiation; the combination of oximetry with questionnaires did not improve their predictive value.https://www.tandfonline.com/doi/10.1016/j.pulmoe.2018.10.004Sleep apneaQuestionnairesESSBerlinStop-BangOximetry
spellingShingle A. Pataka
G. Kalamaras
E. Vlachogianni
P. Argyropoulou
Combination of oximetry and sleep questionnaires as screening tools for CPAP initiation in patients with obstructive sleep apnea
Pulmonology
Sleep apnea
Questionnaires
ESS
Berlin
Stop-Bang
Oximetry
title Combination of oximetry and sleep questionnaires as screening tools for CPAP initiation in patients with obstructive sleep apnea
title_full Combination of oximetry and sleep questionnaires as screening tools for CPAP initiation in patients with obstructive sleep apnea
title_fullStr Combination of oximetry and sleep questionnaires as screening tools for CPAP initiation in patients with obstructive sleep apnea
title_full_unstemmed Combination of oximetry and sleep questionnaires as screening tools for CPAP initiation in patients with obstructive sleep apnea
title_short Combination of oximetry and sleep questionnaires as screening tools for CPAP initiation in patients with obstructive sleep apnea
title_sort combination of oximetry and sleep questionnaires as screening tools for cpap initiation in patients with obstructive sleep apnea
topic Sleep apnea
Questionnaires
ESS
Berlin
Stop-Bang
Oximetry
url https://www.tandfonline.com/doi/10.1016/j.pulmoe.2018.10.004
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