Using Questionnaires to predict OSA in patients presenting to sleep clinics

Brink, A.;Munns, S.;Nolan, G.;Pyne, N.

Abstract

Purpose: In sleep clinics, the Epworth Sleepiness Scale (ESS) and STOP-Bang (SB) questionnaire are widely used to determine the probability that a patient has obstructive sleep apnoea (OSA), though neither were designed as a triaging tool specifically for patients with suspected OSA. Previously we found that ESS had poor correlation with OSA presence and severity as determined by the apnoea-hypopnoea index (AHI) >15. In this paired clinical chart audit, we determined if the SB has improved predictive ability and thus better suitability for triaging sleep clinic patients suspected of OSA compared to ESS. Method: 101 sleep clinic patients (56 male, 45 female) completed both ESS and SB questionnaires and underwent overnight polysomnography (OPSG) to determine AHI. Correlation of ESS and SB to AHI was determined using Spearman’s rho, and predictive ability of each questionnaire was determined using ROC curves and logistic regression. Results: ESS was not significantly correlated to AHI in men (p=0.208) or women (p=0.533) and had poor sensitivity (60.2%) and specificity (47.8%). In contrast, SB was correlated to AHI in both men (p=<.001) and women (p=0.045), and had improved sensitivity (94.1%). An ESS>8 was not predictive of clinically significant OSA (AHI>15, p=0.244), whereas SB>3 was associated with 4.4 times higher odds of clinically significant OSA (p=.007). Discussion: In our cohort, SB is more suitable than ESS for triaging patients presenting to sleep clinics due to its higher predictive ability for OSA. This finding has important implications for OPSG rebates and patient access to publicly funded treatment schemes.

Journal

Sleep Advances

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ISBN/ISSN

2632-5012

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Supplement 1

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Brisbane, Australia

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Oxford University Press

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DOI

10.1093/sleepadvances/zpac029.098