Association between alcohol use disorder and risk of obstructive sleep apnea.

Obstructive sleep apnea (OSA) is a common sleep disorder characterised by recurrent upper airway collapse during sleep. Alcohol consumption has been linked to an increased risk of OSA due to its effects on the upper airway and body mass index (BMI). We aimed to investigate the correlation between alcohol use disorders and OSA. We used 11,859 participants data from Korean National Health and Nutrition Examination Surveys. The variable of interest was alcohol use disorder, measured using the Alcohol Use Disorders Identification Test, and the dependent variable was the risk of OSA, measured using the Snoring, Tiredness, Observed apnea, high blood Pressure, BMI, age, neck circumference, and male gender questionnaires. Multiple logistic regression was used to assess the association between alcohol use disorder and OSA risk after adjusted analysis. A significant association was found between alcohol use disorder and OSA (adjusted odds ratio [aOR] 2.14, 95% confidence interval [CI] 1.93-2.37). In the unemployed group, those with alcohol use disorder had the highest odds of being at risk of OSA compared with those who did not have this disorder (aOR 2.45, 95% CI 2.04-2.95). The OSA risk increased as the snoring frequency, amount of alcohol consumed, and frequency of binge drinking increased. This study suggests an association between alcohol use disorders and the risk of OSA. The frequency of alcohol consumption, quantity of alcohol consumed, and snoring frequency were associated with the risk of OSA. Therefore, ceasing alcohol consumption is recommended as an effective approach to enhancing sleep quality.

Disparities in polysomnography referral in a high-risk cardiac population.

PURPOSE: Obstructive sleep apnea (OSA) is associated with metabolic, cardiovascular, and cerebrovascular comorbidities. Appropriate diagnosis and treatment of OSA might mitigate these comorbidities. This retrospective review sought to assess the impact of sex, age, race, ethnicity, and insurance status on polysomnography (PSG) referral rates. METHODS: An institutional STOP-Bang database of 299,320 patients was filtered for patients admitted to the hospital with an acute cardiac diagnosis between 2015-2020. A cohort of 4,735 patients were risk stratified by STOP-Bang (SB) score and correlations were made between PSG referrals and demographic and clinical variables (sex, age, race, ethnicity, and insurance status). RESULTS: Of the 25.3% of the cohort with high SB scores (5-8) only 21.3% were referred for PSG. Age and female sex were negatively associated with sleep study referrals (p < 0.001). No correlation was found between sleep study referral rates and race or ethnicity. No correlation was found between sleep study referrals and insurance provider. Admitting cardiac diagnosis significantly influenced sleep study referrals with diagnoses of arrhythmias and myocardial infarction being associated with an increased rate of PSG referrals compared to heart failure patients (p < 0.002). CONCLUSIONS: Our study found no significant correlation between PSG referral rates and race, ethnicity, or insurance provider. However, we found low overall rates of PSG referral, with negative correlations between older age and female sex and a high-risk cardiac population. This represents a substantial missed opportunity to identify patients at risk for OSA, obtain a diagnosis, and provider adequate treatment.

Association and interaction effect of shift work and the risk for obstructive sleep apnea on diabetes mellitus in middle-aged Korean workers.

PURPOSE: To investigate the association of shift work and the risk for obstructive sleep apnea (OSA) with diabetes mellitus (DM), and the interaction effect of shift work and the risk for OSA on DM. METHODS: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2019-2021 were used. The participants were 3012 employees aged 40 to 59 years. Shift work was assessed using self-reporting questionnaires. The risk for OSA was assessed by STOP-BANG score. The distribution of demographic factors was calculated using the chi-square test. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated using multivariable logistic regression. An interaction effect between shift work and the risk for OSA on DM was evaluated using relative excess risk owing to interaction (RERI) and attributable proportion (AP) with 95% CIs. The synergic index (SI) was also calculated. RESULTS: Shift work and the risk for OSA were each significantly associated with DM. There was also a significant interaction effect between shift work and the risk for OSA on DM. The RERI was 0.543 (95% CI 0.205-1.361) and the AP was 0.230 (95% CI 0.145-0.342). The SI was 1.662 (95% CI 1.481-1.843). CONCLUSIONS: There was an association and a significant interaction effect of shift work and the risk for OSA on DM. The management of OSA in shift workers should be implemented to prevent DM.

Prevalence of obstructive sleep apnea and its associated factors in primary health care in Morocco.

OBJECTIVE: Obstructive sleep apnea is a common respiratory disorder that is still underdiagnosed in Morocco. This study aims to determine the prevalence of obstructive sleep apnea and its associated factors in primary healthcare. METHODS: In this cross-sectional study, 815 adults aged 18 years and older consulting in the primary health care services in Marrakech, Morocco, were included. We evaluated the risk of obstructive sleep apnea syndrome using the modified STOP-BANG questionnaire. RESULTS: The prevalence of the high risk of obstructive sleep apnea in our sample is 24.8% (CI 95%: 21.7 - 27.6%). The variables independently associated with the high suspicion of obstructive sleep apnea were: gender male (p = 0.001), age ≥ 45 years (p = 0.001), high blood pressure (p = 0.005), hyperlipidemia (p = 0.042), daytime sleepiness (p = 0.003), snoring (p = 0.001), tiredness (p = 0.001) and mandibular retrognathia (p = 0.025). CONCLUSION: This survey revealed a significant prevalence of obstructive sleep apnea in Morocco. Therefore, we propose to generalize the screening of obstructive sleep apnea in hypertensive patients who report symptoms including daytime sleepiness, snoring, nocturnal choking, and tiredness that are unexplained by other known factors.

Inter-night variability of in-home, overnight pulse oximetry screening in an asymptomatic older adult population.

PURPOSE: Obstructive sleep apnoea (OSA) is common, yet often undiagnosed. Self-administered, overnight pulse oximetry (OPO) could screen for OSA in asymptomatic, older populations. However, the inter-night variability of OPO in an asymptomatic, older population is unknown. We determined the inter-night variability of home OPO parameters in an older population and correlated with sleep questionnaires. METHODS: Participants > 50 years without a diagnosis of OSA undertook home OPO for three consecutive nights and completed two sleep questionnaires (STOP-BANG (SBQ) and Epworth Sleepiness Score (ESS)). Analysis was performed with linear mixed models and Spearman's correlation coefficient. RESULTS: There was no difference in oxygen desaturation index (ODI), MeanSpO2, MinimumSpO2, and time spent with SpO2 < 90% (T90) across two or three nights (P ≥ 0.282). However, the variability of all parameters across nights increased with the magnitude of departure from normal values (P ≤ 0.002). All OPO parameters were associated with age (P ≤ 0.034) and body mass index (P ≤ 0.049). There was a weak correlation between three OPO parameters and SBQ (absolute ρ = 0.22 to 0.32; P ≤ 0.021), but not ESS (P ≥ 0.254). CONCLUSION: Inter-night variability of home OPO was minimal when values were near-normal in an older population. However, as values depart from normal, the inter-night variability increases, indicating the need for multiple night recordings. Low correlation to sleep questionnaires suggest the need for more robust OSA questionnaires in an asymptomatic population.

Two-stage screening for obstructive sleep apnea in the primary practice setting.

PURPOSE: To evaluate the effectiveness of a two-stage screening model for obstructive sleep apnea (OSA) in primary care that combines the STOP-BANG questionnaire (SBQ) with an automated home sleep apnea test (HSAT). METHODS: This cross-sectional study was conducted from August 2018 to August 2022 in four Slovenian primary care practices. It included 153 randomly selected patients aged 18 to 70 years who visited the practice for any reason. Participants completed the SBQ and underwent HSAT with type III polygraphy on the same night. The HSAT recordings were scored automatically and by an experienced, accredited somnologist. RESULTS: There was a strong correlation between manual and automated HSAT scorings for the detection of OSA (Pearson's r = 0.93). Cohen's kappa was 0.80 for OSA (respiratory event index (REI) ≥ 5) and 0.77 for OSA severity categorization. The two-stage model demonstrated sensitivity of 64%, a specificity of 97.4%, a positive predictive value (PPV) of 96.0%, a negative predictive value (NPV) of 73.8% and an accuracy of 81.1% for any OSA (REI ≥ 5). For moderate to severe OSA (REI ≥ 15), the model showed 72.7% sensitivity, 96.7% specificity, 85.7% PPV, 92.8% NPV and 91.5% accuracy. CONCLUSIONS: The two-stage model for OSA screening combining the SBQ and automated HSAT was shown to be effective in primary care, especially for moderate and severe OSA. This method provides a practical and efficient approach for the early detection of OSA.

Screening for treatment-required sleep apnoea in patients with spinal cord injury within one year after injury in a rehabilitation setting.

PURPOSE: The current study aims to assess the efficacy of the Stop-Bang Questionnaire (SBQ) in screening treatment-required sleep apnoea following Spinal Cord Injury (SCI). Additionally, we explore the performance of combined questionnaires and pulse oximetry to determine the most cost-effective method. METHODS: The study employs a cross-sectional observational design. All patients admitted to in-hospital rehabilitation at the Spinal Cord Injury Centre of Western Denmark from September 2022 to February 2023 were continuously enrolled. Participating patients underwent SBQ screening, a standard sleep questionnaire, and cardiorespiratory monitoring, followed by an individual consultation with a physician. RESULTS: During the study period, 35 SCI patients were admitted, with 24 providing informed consent. Among the 24 included patients, there was a 75% prevalence of mild to severe sleep apnoea, and 46% had treatment-required sleep apnoea. The SBQ missed only one patient with treatment-required sleep apnoea but misclassified eight patients. Combining SBQ with the pulse oximetry demonstrated the best performance in identifying patients with sleep apnoea. CONCLUSION: The study indicates that SBQ alone is insufficient for screening treatment-required sleep apnoea. Exploratory analysis suggests that combining SBQ with a simple pulse oximetry measurement might enhance accuracy.

Risk of obstructive sleep apnea among health workers: results of a screening in a large Italian University Hospital.

PURPOSE: Obstructive sleep apnea (OSA) is a common respiratory sleep disorder, related to increased mortality, poor quality of life, and higher risk of work accidents and injuries. Studies on the risk of OSA (rOSA) among health workers (HW) are scant. The aims of this study were to investigate this issue in a large University Hospital and to assess the effectiveness of a screening program. METHODS: The STOP-BANG questionnaire (SBQ) was sent via e-mail to the 5031 HW employed at the University Hospital of Verona. HW who completed the SBQ were classified at low, moderate, and high rOSA. HW at high rOSA were invited to undergo nocturnal polygraphy. The determinants of rOSA were studied by non-parametric Kruskal-Wallis test, Pearson's chi-squared, and multinomial logistic model. RESULTS: Of 5031 HW, 1564 (31.1%) completed the online questionnaire. Responders with low, moderate, and high rOSA were 72.7%, 13.7%, and 13.6%. Male gender, older age, and higher body mass index (BMI) were significant predictors of high rOSA, as expected. Physicians had the lowest probability of being in the high-risk category. Polygraphy was performed in 64 subjects. The positive predictive value of the self-administered SBQ was 68.8% (95%C.I. 55.9-79.8%) but raised to 96.9% (95%C.I. 89.2-99.6%) when re-administered by medical staff. CONCLUSION: SBQ showed its effectiveness as a screening tool in detecting undiagnosed OSA in HW. Systematic screening for OSA in work settings could allow early diagnosis and treatment, reducing short- and long-term health effects of OSA.

Utility of the psychomotor vigilance task in screening for obstructive sleep apnoea.

PURPOSE: The study aimed to assess the performance of the PVT in patients with suspected OSA, evaluate its role in population screening for OSA. METHODS: The NoSAS, STOP-Bang, ESS scores and PVT tests were performed after suspected OSA patients' admission, followed by PSG. Then we compared the PVT results, calculated the sensitivity, specificity and ROC curve of PVT, and analyzed the accuracy of STOP-Bang and NoSAS questionnaire combined with PVT in predicting OSA. RESULTS: A total of 308 patients were divided into four groups based on AHI: primary snoring (2.74 ± 1.4 events/h, n = 37); mild OSA (9.96 ± 3.25 events/h, n = 65); moderate OSA (22.41 ± 4.48 events/h, n = 76); and, severe OSA (59.42 ± 18.37 events/h, n = 130). There were significant differences in PVT lapses (p < 0.001) and reaction time (RT, p = 0.03) among the four groups. The PVT lapses and RT were positively correlated with AHI (p < 0.001) and ODI (p < 0.001), and negatively correlated with LSpO2 (p < 0.001). When diagnosing OSA (AHI ≥ 5 events/h), the AUCs of PVT, ESS, STOP-Bang, and NoSAS were 0.679, 0.579, 0.727, and 0.653, respectively; the AUCs of STOP-Bang and NoSAS combined with PVT increased. After combined PVT, the diagnostic specificity of STOP-Bang and NoSAS at nodes with AHI ≥ 5, ≥ 15 and ≥ 30 events/h increased to varying degrees. CONCLUSION: Patients with OSA exhibited impairment in the PVT, and the combination of the PVT and STOP-Bang or NoSAS scores can improve the diagnostic efficacy and specificity for OSA.

Accuracy and modification of the STOP-bang questionnaire for screening patients with obstructive sleep apnea in China.

Despite the high sensitivity of the STOP-Bang questionnaire [snoring, tiredness, observed apneas, high blood pressure, body mass index, age, neck size, gender] questionnaire (SBQ), which is widely used to screen individuals at high risk of obstructive sleep apnea (OSA), few studies have evaluated the discrimination related to sex in the SBQ. Therefore, our study aimed to assess whether SBQ performance is gender-related and modified by changing body mass index (BMI) and neck circumference (NC) cut-off values. A total of 470 patients attended the sleep centres. They were divided into moderate-to-severe OSA and non-moderate-to-severe OSA groups based on the apnea-hypopnea index (AHI) and the results of the SBQ screening. The predictive performance of the SBQ screening instrument was evaluated by 2 × 2 contingency tables and discriminatory ability, which was estimated from the area under the curve (AUC) obtained from receiver operating characteristic curve. Our results suggest that when screening for moderate-to-severe OSA, the original SBQ has higher sensitivity and lower specificity for men; however, women have higher specificity and lower sensitivity. The SBQ achieved the maximum AUC of 0.783 for men and 0.634 for women when the BMI cut-off value was established at 30 kg/m2 and the NC cut-off value was established at 38 cm in men, and the BMI cut-off value was established at 25 kg/m2 and the NC cut-off value at 36 cm in women. Balancing the optimal sensitivity and specificity, the cut-off value of the optimal modified SBQ total scores for men was determined to be ≥4 and ≥3 for women.

Prevalence of risk and factors associated with obstructive sleep apnea-hypopnea syndrome in an adult population in Kinshasa, Democratic Republic of Congo.

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is an underdiagnosed and lesser known disease in sub-Saharan Africa. We believe that this is the first descriptive and analytical cross-sectional study in Kinshasa (from February 1 to October 31, 2021), which included respondents aged ≥18 years. The study aimed to determine the prevalence of the risk and factors associated with OSAHS. Each participant signed a free and informed consent. Statistical analyses were performed using XLStat 2020 and the Statistical Package for the Social Sciences version 24 for Windows. Odds ratios (ORs) were calculated to determine the degree of association between these variables and a high risk of OSAHS. The significance threshold was p < 0.05 and confidence interval (CI) at 95%. There were 4,162 participants, including 2,287 men (54.9%), with an mean (SD) age of 32 ± 12.6 years. The prevalence of OSAS risk was 17.4% and 7.9% for men and women, respectively. The associated risk factors were male sex (OR 4, 95% CI 3.20-5.54), hypertension (OR 6.7, 95% CI 4.87-9.30), age ≥60 years (OR 8.7, 95% CI 4.07-18.88), obesity/overweight (OR 1.94, 95% CI 1.13-3.78), and excessive daytime sleepiness (OR 2.63, 95% CI 2.05-3.56). The risk of OSAS in Kinshasa is high and it increases with age, male sex, obesity, and hypertension. The Snoring, Tiredness, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, and male Gender (STOP-BANG) questionnaire is an easy-to-use tool for diagnostic orientation.

STOP-Bang Questionnaire Is Associated With Aortic Remodeling in Patients With Acute Type B Aortic Dissection Undergoing Standard Thoracic Endovascular Aortic Repair.

PURPOSE: To determine whether the STOP-Bang questionnaire, which is a tool for evaluating obstructive sleep apnea, is associated with aortic remodeling after thoracic endovascular aortic repair (TEVAR) in patients with type B aortic dissection (TBAD). METHODS: Patients with TBAD who underwent standard TEVAR at our center from January 2015 to December 2020 were enrolled. For the included patients, we recorded baseline characteristics, comorbidities, preoperative computed tomographic angiography findings, procedure details, and complications. The STOP-Bang questionnaire was administered to each patient. Total scores comprised points for 4 yes/no questions and 4 clinical measurements. STOP-Bang ≥5 and STOP-Bang <5 groups were then created using the STOP-Bang total scores. We evaluated aortic remodeling 1 year after discharge and the reintervention rate, as well as false lumen complete thrombosis (FLCT) and non-FLCT length. RESULTS: Fifty-five patients were enrolled in the study; STOP-Bang <5, n=36, and STOP-Bang ≥5, n=19. Compared with the STOP-Bang ≥5 group, the STOP-Bang <5 group achieved statistically significantly higher descending aorta positive aortic remodeling (PAR) rates in zones 3 to 5 (zone 3: p=0.002; zone 4: p=0.039; zone 5: p=0.023), higher total descending aorta-PAR rate (66.7% vs 36.8%, respectively; p=0.004), and lower reintervention rate (8.1% vs 38.9%, respectively; p=0.005). In the logistic regression analysis, STOP-Bang ≥5 had an odds ratio of 0.12 (95% confidence interval: 0.03-0.58; p=0.008). There was no significant difference in overall survival between the groups. CONCLUSION: STOP-Bang questionnaire scores were associated with aortic remodeling after TEVAR in patients with TBAD. Increasing the frequency of surveillance after TEVAR might be beneficial in these patients. CLINICAL IMPACT: We analysed aortic remodelling 1 year after thoracic endovascular aortic repair (TEVAR) in acute type B aortic dissection (TBAD) patients with STOP-Bang < 5 and STOP-Bang ≥ 5. Aortic remodelling was better, and the reintervention rate was higher in patients with STOP-Bang < 5 compared with patients with STOP-Bang ≥ 5. In patients with STOP-Bang ≥ 5, aortic remodelling was worse in zones 3-5 compared with zones 6-9. This study suggests that the STOP-Bang questionnaire results is associated with aortic remodelling after TEVAR in patients with TBAD.

Sleep quality in women with diabetes in pregnancy: a single-center retrospective study.

PURPOSE: Sleep quality is an important indicator of individual quality of life, which not only affects people's mental health but is also closely related to the occurrence of many diseases. Sleep disorders associated with diabetes in pregnancy can greatly endanger the health of both mothers and babies, and their hazards are strongly associated with blood glucose levels. This study explored the quality of sleep and sleep disorders in pregnant women with diabetes. METHODS: From June 2020 to July 2021, a total of 693 patients diagnosed with diabetes during pregnancy in Gansu Provincial Maternal and Child Health Hospital were used as the experiment group, including 626 patients with gestational diabetes mellitus (GDM) and 67 patients with pregestational diabetes mellitus (PGDM). At the same time, 709 women not having diabetes were randomly selected as the control group. To obtain the general situation of the participants, the participants were surveyed using the Pittsburgh Sleep Quality Index (PSQI) and the STOP-BANG (S, Snoring; T, Tiredness; O, Observed apnea; P, high blood Pressure; B, Body mass index > 35 kg/ m2; A, Age > 50 years; N, Neck circumference > 40 cm; G, male Gender) questionnaire. The differences in sleep quality and obstructive sleep apnea-hypopnea syndrome (OSAHS) were analyzed between the experiment group and the control group by using chi-square and t-test, and the clinical features and related factors of sleep disorder were analyzed. RESULTS: Compared with the control group, the age, pre-pregnancy weight, body mass index (BMI), and neck circumference were larger in the experimental group (P < 0.05). The experimental group had higher PSQI scores for sleep quality, time to fall asleep score, sleep duration, sleep efficiency, sleep disorder, and daytime dysfunction than the control group (all P < 0.001). Specific analysis of the clinical features of sleep disorders indicated that the experimental group scored higher than the control group (P < 0.05). The analysis of the types of daytime dysfunction showed that the experiment group scored higher in terms of frequently feeling sleepy and lack of energy to do things than the control group (P < 0.05). Analysis of STOP-BANG scores indicated that the proportion of patients with GDM or PGDM having fatigue, hypertension, BMI > 35 kg/m2, and neck circumference > 40 cm was higher than that in the control group (P < 0.05). According to regression analysis, sleep quality of patients with GDM was significantly impacted by the increases in age (OR: 1.243, CI:1.197-1.290), neck circumference (OR: 1.350, CI: 1.234-1.476), PSQI score (OR: 2.124, CI:1.656-2.724), and sleep efficiency score (OR: 3.083, CI:1.534-6.195), whereas that of patients with PGDM was impacted by age (OR: 1.191, CI:1.086-1.305), neck circumference (OR: 1.981, CI: 1.469-2.673), and PSQI score (OR: 7.835, CI: 2.383-25.761). CONCLUSIONS: Pregnant women with diabetes had poorer sleep quality and a higher risk of developing OSAHS than those without diabetes. There may be some link between sleep quality and the onset of diabetic.

Validity of the new 'Top End Sleepiness Scale' against the STOP-Bang tool in predicting obstructive sleep apnoea among Indigenous Australian adults.

BACKGROUND: The validity of the newly developed sleepiness assessment tool, the 'Top End Sleepiness Scale' (TESS), against other established obstructive sleep apnoea (OSA) screening tools has not been evaluated. AIMS: To compare the utility and validity of the culturally safe and clinically relevant subjective daytime sleepiness assessment tool, the 'TESS' was used among Indigenous Australians against STOP-Bang screening tool for predicting OSA in a regional and remote Indigenous Australian cohort. METHODS: The TESS questionnaire, consisting of pictorial representations of six items representing daily activities that would induce daytime sleepiness specific for Indigenous Australians, was assessed for its correlation in predicting moderate to severe OSA according to Apnoea-Hypopnoea Index (AHI, ≥15) against the STOP-Bang screening tool. RESULTS: Eighty Indigenous Australian patients (51% male; mean age 45.1 ± 11.5 years) were included in this study with the majority (n = 70; 88%) having OSA, of which 65 (93%) had an AHI ≥ 15. Area under the curve statistics for overall scores showed no significant difference between TESS or STOP-Bang in the prediction of OSA (P = 0.16). A moderate risk score of TESS (≥3) was superior to STOP-Bang (score 3-4) in sensitivity (84% vs 33%) and specificity (39% vs 30%). The sensitivity for a high-risk score for the STOP-Bang (≥5) was superior to the TESS (≥8; 60% vs 33%), although specificity was comparable (83% vs 91% respectively). CONCLUSIONS: The TESS screening tool could be a useful standalone or could be adopted alongside the STOP-Bang OSA screening tools in the clinical assessment of sleep disorders among Indigenous Australians.

Relationship between obstructive sleep apnea, insulin resistance, and metabolic syndrome: a nationwide population-based survey.

We aimed to identify the association between obstructive sleep apnea (OSA), insulin resistance (IR), and metabolic syndrome (MetS) in a nationwide population-based sample. A total of 7,900 adults with information on the STOP-Bang score and MetS (3,341 men and 4,469 women) were identified from the dataset of the Korea National Health and Nutrition Examination Survey 2019-2020. The association between OSA, IR, MetS, and its components was estimated using complex sample logistic regression analysis with adjustments for age, body mass index, residence, smoking status, alcohol consumption, household income, education, and the presence of diabetes. Participants with a high OSA score were more likely to have IR (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.96-3.95 in men and OR 2.64, 95% CI 0.55-12.80 in women), MetS (OR 6.05, 95% CI 4.23-8.69 in men and OR 4.20, 95% CI 1.23-15.70 in women), and components of MetS, compared to individuals with a low OSA score. Compared to premenopausal women, postmenopausal women had a more intense association between OSA and IR (OR 1.78, 95% CI 0.13-24.43 for premenopausal women and OR 3.64, 95% CI 0.60-22.28 for postmenopausal women) and MetS (OR 2.58, 95% CI 0.23-29.55 for premenopausal women and OR 5.36, 95% CI 1.42-20.21 for postmenopausal women). OSA was associated with abdominal obesity and hypertension in premenopausal women, while all components of MetS were associated with OSA in postmenopausal women. Further studies are necessary to elucidate the underlying mechanisms of these findings.

Comparison of the value of the STOP-BANG questionnaire with oxygen desaturation index in screening obstructive sleep apnea in Germany.

PURPOSE: Despite polysomnography being the gold standard method of diagnosing obstructive sleep apnea (OSA), it is time-consuming and has long waiting lists. Alternative methods including questionnaires and portable sleep devices have been developed to increase the speed of diagnosis. However, most questionnaires such as the STOP-BANG questionnaire (SBQ) are limited due to low specificity. This study evaluated the value of SBQ to screen for OSA and compared it with the oxygen desaturation index (ODI) and their combination. METHODS: This retrospective study included patients who completed the SBQ and underwent a night at the sleep lab or home sleep testing. The ODI was extracted from these sleep study reports. The combination of SBQ with ODI and their individual scores were compared with apnea-hypopnea index (AHI) in terms of their accuracy in diagnosing OSA. Sensitivity, specificity, and area under the curve (AUC) for different severities of OSA were calculated and compared. RESULTS: Among 132 patients, SBQ showed a sensitivity of 0.9 and a specificity of 0.3 to screen for OSA. As the severity of OSA increased, the sensitivity increased whilst specificity decreased for both measurements. ODI achieved an increased specificity of 0.8 and could correctly diagnose OSA 86% of the time which was better than SBQ's 60%. For all severities of OSA, ODI alone displayed a larger AUC than SBQ and similar AUC to their combination. CONCLUSION: ODI produced a higher specificity and AUC than SBQ. Furthermore, ODI combined with SBQ failed to increase diagnostic value. Therefore, ODI may be the preferred way to initially screen patients for OSA as an easy-to-use alternative compared to SBQ.

Stop-bang questionnaire for screening obstructive sleep apnea syndrome among hypertensive patients in Kenya.

INTRODUCTION: Obstructive sleep apnea (OSA) is a type of breathing problem during sleep caused by the blockage of the upper airway, which can cause cessation of airflow. There is limited research on the prevalence of OSA in hypertensive patients in sub-Saharan Africa (SSA). The study aimed to describe the prevalence and clinical characteristics of OSA among hypertensive patients at a tertiary hospital in Nairobi, Kenya. METHODS: This cross-sectional study was conducted at the Aga Khan University Hospital in Nairobi, Kenya. Two hundred and fifty-one hypertensive patients were screened for OSA risk using the STOP-Bang questionnaire (SBQ). Patients with a SBQ score of ≥ 4 were categorized as high risk for OSA. Descriptive statistics were employed to describe both categorical and continuous variables and binary logistic regression to assess factors associated with the high risk of OSA. RESULTS: The study reported that 78.5% of the participants had high-risk OSA. The median age and body mass index (BMI) were 57.0 years (IQR: 50.0-64.0) and 28.3 kg/m2, respectively. Age, neck circumference, gender, and BMI were significantly higher in the high-risk OSA group as compared to the low-risk group. CONCLUSION: The study highlights the importance of screening hypertensive patients for OSA using the SBQ in clinical settings, particularly in low-and middle-income countries (LMICs). Healthcare providers can use patient characteristics such as age, gender, neck circumference, and BMI to identify those at greater risk of developing OSA. Further research could focus on developing effective OSA prevention and treatment interventions in hypertensive patients.

The association between long working hours and obstructive sleep apnea assessed by STOP-BANG score: a cross-sectional study.

PURPOSE: The relationship between night-shift work and obstructive sleep apnea (OSA) is well known, but that between OSA and long working hours is still unknown. This study explores the association between long working hours and OSA. METHODS: Using cross-sectional Korean National Health and Nutrition Examination Survey 2020 data, we made multiple logistic regression models to calculate odds ratios (ORs) between weekly working hours and STOP-BANG scores for OSA screening. Stratified regression models by night or rotating shift work were also made. RESULTS: In an adjusted model of STOP-BANG high-risk versus low-risk groups, the OR in the group exceeding 40 h/wk was higher but not statistically significant, 1.19 [95% confidence interval (CI) 0.66-2.15] compared to the group working 40 h/wk (standard working hours) or less. In the group exceeding 52 h/wk, the OR was 2.03 with statistical significance (95% CI 1.08-3.80). In the stratification analysis of daytime and night-shift work, the daytime worker results were similar to those in the non-stratified model. The point estimation values of ORs in the night-shift workers were higher than in the daytime workers; however, we did not observe a statistical significance. CONCLUSION: Long working hours can increase the risk of OSA assessed by STOP-BANG scores.

Can functional septoturbinoplasty, with or without nasal valve suspension suture (FSTVS), alter the initial findings of drug-induced sleep endoscopy (DISE) in patients with obstructive sleep apnea syndrome (OSAS)?

BACKGROUND: Drug-induced sleep endoscopy (DISE) is routinely performed to assess the upper airway collapse in patients with obstructive sleep apnea syndrome (OSAS). Its purpose is to identify cases of multilevel collapse, which helps to determine the appropriate surgical approach. The current proposal to analyze the functional septoturbinoplasty with or without nasal valve suspension suture (FSTVS) has the potential to change the original findings of DISE in OSAS patients who were initially planned for one-stage multilevel surgery based on the pre-FSTVS DISE results. STUDY DESIGN: Prospective study. METHODS: All OSAS patients with moderate to severe symptoms who underwent DISE pre-FSTVS and noticed multilevel collapse were subjected to post-FSTVS re-evaluation using DISE at three-month intervals. RESULT: This study included a total of thirty-two patients, with males outnumbering females in a ratio of 15:1. The average age of the patients was 38.88 years (standard deviation, SD ± 10.12), and the mean body mass index (BMI) was 28.66 (SD ± 3.73). Significant improvements (p = 0.0417) were observed in both pre- and post-FSTVS measurements at three-month intervals, as well as in the Epworth sleepiness score (ESS). Enhancements in the apnea-hypopnea index (AHI) and snoring event post-FSTVS were also observed. Around 50% of the patients exhibited concentric collapse at the velum, lateral collapse at the oropharynx, and anteroposterior (AP) collapse at the tongue base. Post-FSTVS, the dynamics at the velum were modified by 23.33%, at the oropharynx by 10%, at the tongue base by 11.76%, and at the epiglottis by 23.07%. One patient who did not experience collapse at the tongue base pre-FSTVS exhibited partial collapse after the procedure. Moreover, all cases of complete AP collapse of the epiglottis changed to partial collapse. CONCLUSION: Our study confirms that FSTVS may offer a simpler and more accessible approach for patients with OSAS. It is a viable option to consider even prior to DISE in clinical anticipated multilevel collapse. By conducting DISE at intervals subsequent to addressing nasal resistance through surgery, valuable insights can be obtained regarding the collapsibility of the upper airway. These findings can guide surgical interventions, ultimately resulting in improved outcomes for patients.

Validation of an obstructive sleep apnea symptom inventory in persons with multiple sclerosis.

BACKGROUND: Improved screening for obstructive sleep apnea (OSA) could enhance multiple sclerosis (MS) clinical care; yet the utility of current screening tools for OSA have yet to be evaluated in persons with multiple sclerosis (PwMS). OBJECTIVES: The STOP-Bang Questionnnaire is an 8-item screening tool for OSA that is commonly used in non-MS samples. The aim of this study was to assess the validity of the STOP-Bang in PwMS. METHODS: STOP-Bang and polysomnography data were analyzed from n = 200 PwMS. Sensitivity, specificity, positive-, and negative-predictive value (PPV and NPV) were calculated, with receiving operating characteristic (ROC) curves, for each STOP-Bang threshold score, against polysomnography-confirmed OSA diagnosis at three apnea severity thresholds (mild, moderate, and severe). RESULTS: Nearly 70% had a STOP-Bang score of ⩾3% and 78% had OSA. The STOP-Bang at a threshold score of 3 provided sensitivities of 87% and 91% to detect moderate and severe OSA, respectively; and NPV of 84% and 95% to identify PwMS without moderate or severe OSA, respectively. Sensitivity to detect milder forms of OSA was 76%. The NPV to identify persons without milder forms of OSA was 40%. CONCLUSION: The STOP-Bang Questionnaire is an effective tool to screen for moderate and severe OSA in PwMS, but may be insufficient to exclude mild OSA.