Association between health-related behaviors and obstructive sleep apnea among Korean adults.

We aimed to investigate the association between health-related behaviors and obstructive sleep apnea (OSA) among Korean adults. A cross-sectional design using national open data was employed. Data from 8,096 adults aged 40 years and above who participated in the Korea National Health and Nutrition Examination Survey between 2019 and 2021 were analyzed. The participants' OSA risk level was assessed using the STOP-Bang questionnaire. A logistic regression analysis was performed to investigate the association between health-related behaviors and high risk for OSA. The association between health-related behaviors and OSA risk remained significant for former smokers (OR = 1.643) and high-risk drinking (OR = 1.365), after adjusting for variables that showed significant differences in general and metabolic characteristics. Implementing lifestyle modifications is crucial for mitigating the health and societal impact of OSA. Understanding and addressing modifiable risk factors, including high-risk drinking and smoking, should be prioritized in nursing intervention. Nursing interventions are critical for preventing and managing OSA among Korean adults. Prioritizing high-risk behaviors through cessation programs and education is essential. Vulnerability of individuals living alone must be addressed through community outreach and support services. Emphasizing routine screenings for pre-hypertension and pre-diabetes, promoting balanced nutrition, and encouraging physical activity are crucial.

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.

Relationship between sleep bruxism and obstructive sleep apnoea: A population-based survey.

OBJECTIVE: Sleep bruxism (SB) and obstructive sleep apnoea (OSA) seem to be mutually associated. This study investigates the relationship between current SB and OSA-related symptoms and the difference in OSA-related symptoms between groups based on a history of SB. METHODS: An online survey was drafted to report the presence of SB and OSA in sample of 243 individuals (M = 129;F = 114;mean(SD)age = 42.4 ± 14.4 years). The Subject-Based Assessment strategy recommended in the 'Standardized Tool for the Assessment of Bruxism' (STAB) was adopted to assess SB. To evaluate OSA-related symptoms, Epworth Sleepiness Scale (ESS) and STOP-BANG questionnaires were adopted. Correlations between current SB and OSA-related symptoms were evaluated by Spearman test. ESS and STOP-BANG scores were compared by Mann-Whitney U test in individuals with and a without positive SB history. RESULTS: Current SB and SB history were reported by 45.7% and 39.1% of the sample, respectively. 73.7%, 21% and 5.3% of the responders showed a low, intermediate and high risk of OSA, respectively. Neither significant correlations between current SB and OSA nor significant differences between SB groups emerged. CONCLUSIONS: This study did neither find any significant correlation between self-report of current SB and OSA nor significant differences in ESS and STOP-BANG scores between groups based on SB history.

The STOP-Bang questionnaire: A narrative review on its utilization in different populations and settings.

STUDY RATIONALE: Although the STOP-Bang questionnaire has been validated for its efficacy and diagnostic performance in various settings, there is no review that summarizes the pertinent evidence of the STOP-Bang questionnaire in the different populations. We aimed to review the evidence of the diagnostic performance of the STOP-Bang questionnaire, correlation between STOP-Bang scores and the probability of obstructive sleep apnea (OSA), and its clinical application in various populations. STUDY IMPACT: This review guides healthcare providers in the sleep medicine and perioperative medicine disciplines to be better informed when using the STOP-Bang questionnaire in the different populations. It provides a greater understanding for both patients and clinicians when making decisions regarding OSA screening for each population.

Screening Tools for Obstructive Sleep Apnea in Pregnant Women: An Extended and Updated Systematic Review and Meta-analysis.

The prevalence of obstructive sleep apnea syndrome (OSA) increases in women during pregnancy and negatively affects maternal and fetal outcomes. The updated systematic review and meta-analysis aimed to evaluate the validity of the Berlin, STOP-Bang, and Epworth sleepiness scale (ESS) questionnaires in detecting OSA in pregnant women. PubMed, Embase, and Web of Science were searched systematically up to March 2022. After eligible studies inclusion, two independent reviewers extracted demographic and clinical data. Bivariate random effects models were used to estimate the pooled accuracy measures including sensitivity and specificity, positive (PPV) and negative predictive values (NPVs), diagnostic odds ratio (DOR), and receiver operating characteristic curve (ROC) curve. We included 8 studies including 710 pregnant women with suspected OSA. The performance values of Berlin, STOP-Bang, and ESS questionnaires were as follows: the pooled sensitivity were 61% (95% confidence interval (CI): 40%-80%), 59% (95% CI: 49%-69%), and 29%, (95% CI: 10%-60%); pooled specificity were 61% (95% CI: 42%-78%), 80% (95% CI: 55%-93%), and 80% (95% CI: 50%-94%); pooled PPVs were 60% (95% CI: 0.49-0.72), 73% (95% CI: 61%-85%), and 59% (95% CI: 31%-87%); pooled NPVs were 60% (95% CI: 0.49-0.71), 65% (95% CI: 54%-76%), and 53% (95% CI: 41%-64%); and pooled DORs were 3 (95% CI: 1-5), 6 (95% CI: 2-19), and 2 (95% CI: 1-3), respectively. It seems that the Berlin, STOP-Bang, and ESS questionnaires had poor to moderate sensitivity and specificity in pregnancy, with the ESS showing the worst characteristics. Further studies are required to evaluate the performance of alternative screening methods for OSA in pregnancy.

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.

Profile of Patients With Obstructive Sleep Apnea: An Initial Experience in a Tertiary Health Facility.

Introduction Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder with increasing prevalence worldwide. The disease is, however, underdiagnosed in many resource-limited countries, especially in sub-Saharan Africa with unknown prevalence. Study aim The aim of this study was to determine the demographic and clinical characteristics, as well as measured sleep study parameters of suspected OSA patients. Methods The study was a retrospective review of the clinical characteristics and home sleep study reports of patients seen at the respiratory and sleep clinic from January 2020 to June 2022. Descriptive statistics such as means, medians, and percentages were employed to summarize the data using tables and graphs. Spearman correlation coefficient and Fisher's exact test were used to determine associations between the variables. Findings The study participants were predominantly male, and 64.7% were ≥50 years of age. Approximately 76% of the cases had moderate-to-severe OSA based on the apnea-hypopnea index (AHI) scores with a mean BMI of 38.4kg/m2 and 43.1kg/m2, respectively (p=0.013), and a mean STOP-BANG score of 5.2 and 6.2, respectively (p <0.001). There was a positive correlation between AHI scores and BMI of the patients (r=0.252, p=0.003), as well as with their STOP-BANG scores (r=0.436, p< 0.001). Oxygen desaturation index (ODI) parameters of participants also positively correlated with the AHI scores (r=0.872, p<0.001). Conclusion The proportion of patients with moderate-to-severe OSA was high. Obesity was significantly associated with AHI scores, which also positively correlated with the STOP-BANG and ODI scores. These results suggest that the burden of OSA, which is closely linked with obesity, could be underestimated in Ghana and requires epidemiological studies in the very near future to clearly define and anticipate its impact on the health economy of Ghana.

Identifying the optimal STOP-Bang screening score for obstructive sleep apnea among bariatric surgery patients.

BACKGROUND: Undiagnosed obstructive sleep apnea (OSA) increases the risk of perioperative complications in bariatric patients. Validated screening methods exist, but are not specific to patients with severe obesity. OBJECTIVES: Determine the ideal OSA screening tool for bariatric surgery patients balancing accuracy and cost-effectiveness. SETTING: University Hospital. METHODS: Bariatric surgery patients from January 2018 to September 2023 were identified from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. For patients with a STOP-Bang score of ≥4 referred for polysomnogram additional variables were collected from the electronic medical record. The Berlin Score was retrospectively calculated. RESULTS: Out of 484 patients who underwent bariatric surgery, 167 (34.5%) had a STOP-Bang score ≥4. The receiver operating characteristic (ROC) curve for STOP-Bang scores ≥4 had an area under the curve (AUC) of 78.5% for predicting OSA and 83.7% for OSA requiring treatment (Apnea Hypopnea Index [AHI] ≥ 15), compared to Berlin Scores' AUC of 80.7% and 88.6%, respectively. A STOP-Bang score of 4 had a sensitivity of 55.6% and specificity of 36.8%, while a score of 5 had 29.3% and 66.2%, respectively. A Berlin Score of 3 had a sensitivity of 47.5% and specificity of 69.1%, with 30 patients (44.1%) starting OSA treatment. Thirty-five patients (21%) experienced a delay in insurance submission, averaging 41.5 days, related to OSA workup. CONCLUSION: The Berlin questionnaire outperforms STOP-Bang in predicting OSA requiring treatment. Raising the polysomnography referral score from STOP-Bang ≥4 to ≥5 or utilizing a Berlin Score of ≥3, may alleviate resource burden, reduce costs, and expedite medical optimization for bariatric surgery.

Prevalence and regional distribution of obstructive sleep apnea in Canada: Analysis from the Canadian Longitudinal Study on Aging.

OBJECTIVES: Obstructive sleep apnea (OSA) is a common chronic condition that is often undiagnosed or diagnosed after many years of symptoms and has an impact on quality of life and several health factors. We estimated the Canadian national prevalence of OSA using a validated questionnaire and physical measurements in participants in the Canadian Longitudinal Study on Aging (CLSA). METHODS: The method used individual risk estimation based upon the validated STOP-BANG scale developed for OSA. This stratified population sample spans Canada to provide regional estimates. RESULTS: In this sample of adults aged 45 to 85 years old, the overall prevalence in 2015 of combined moderate and severe OSA in the 51,337 participants was 28.1% (95% confidence intervals, 27.8‒28.4). The regional prevalence varied statistically between Atlantic Canada and Western Canada (p < 0.001), although clinically the variations were limited. The provincial prevalence for moderate and severe OSA ranged from 27.5% (New Brunswick and British Columbia) to 29.1% (Manitoba). Body mass index (BMI) was the dominant determinant of the variance between provinces (ß = 0.33, p < 0.001). Only 1.2% of participants had a clinical diagnosis of OSA. CONCLUSION: The great majority (92.9%) of the participants at high risk of OSA were unrecognized and had no clinical diagnosis of OSA.

RéSUMé: OBJECTIFS: Le syndrome de l'apnée du sommeil (SAS) est une maladie chronique courante qui est souvent non diagnostiquée ou diagnostiquée plusieurs années après l'apparition de symptômes et qui a un impact sur la qualité de vie ainsi que plusieurs autres facteurs de santé. Nous avons estimé la prévalence nationale canadienne du SAS à l'aide d'un questionnaire validé et de mesures physiques chez les participants de l'Étude longitudinale canadienne sur le vieillissement (ÉLCV). MéTHODES: L'étude mesure l'estimation du risque individuel du SAS basée sur l'échelle validée STOP-BANG qui a été développée pour l'évaluation du SAS. Cet échantillon de population stratifié couvre tout le Canada et permet de fournir des estimations régionales. RéSULTATS: Dans cet échantillon d'adultes âgés de 45 à 85 ans, la prévalence globale du SAS modéré et sévère chez les 51 337 participants était de 28,1 % en 2015 (intervalles de confiance à 95 %: 27,8‒28,4). La prévalence régionale variait statistiquement entre le Canada atlantique et l'ouest du Canada (p < 0,001), bien que les variations cliniques soient limitées. La prévalence provinciale du SAS modéré et sévère variait entre 27,5 % (Nouveau-Brunswick et Colombie-Britannique) et 29,1 % (Manitoba). L'indice de masse corporelle représentait le facteur dominant de la variance entre les provinces (ß = 0,33, p < 0,001). Seulement 1,2 % des participants avaient un diagnostic clinique du SAS. CONCLUSION: La grande majorité (92,9 %) des participants présentant un risque élevé du SAS n'étaient pas identifiés auparavant et n'avaient aucun diagnostic clinique du SAS.

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.

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.

Sleep Apnea and Atrial Fibrillation: Clinical Features and Screening Diagnostic Options.

INTRODUCTION: Obstructive sleep apnea (OSA) is associated with an increased risk of hypertension, coronary artery disease, heart failure (HF), and atrial fibrillation (AF). MATERIALS AND METHODS: A total of 179 patients aged 34-81 years were included in the study. The median age was 63 years (interquartile range: 56-69 years). Of these patients, 105 (58.7%) were men, and 74 (41.3%) were women; there were cases of paroxysmal (n = 99), persistent (n = 64), and permanent AF (n = 16). All patients underwent investigations including respiratory sleep monitoring, echocardiography, and 24 h Holter electrocardiography monitoring. Statistical analyses were performed using IBM SPSS Statistics 26.0. RESULTS: OSA was detected in 131 (73.2%) patients. In patients with OSA, paroxysmal AF was commonest (n = 65), followed by persistent AF (n = 51) and permanent AF (n = 15). The patients with sleep apnea had increased body mass index (33.6 kg/m2; p = 0.02), waist circumference (114 cm; p < 0.001), and neck circumference (42 cm; p < 0.001) values. HF (OR 2.9; 95% CI: 1.4-5.9; p = 0.004) and type 2 diabetes (OR 3.6; 95% CI: 1.5-8.3; p = 0.001) were more common in patients with AF and OSA. The STOP-BANG scale (AUC = 0.706 ± 0.044; 95% CI: 0.619-0.792; p < 0.001) and the Berlin questionnaire (AUC = 0.699 ± 0.044; 95% CI: 0.614-0.785) had a higher predictive ability for identifying sleep apnea. CONCLUSIONS: Patients with AF demonstrate a high prevalence of OSA and an increased association with cardiovascular comorbidities. The STOP-BANG scale and the Berlin questionnaire can be used to screen for OSA in patients with AF.

The Association of Serum Uric Acid with Risk of Obstructive Sleep Apnea: The Korean National Health and Nutrition Examination Survey 2019-2021.

Upper airway collapse and apneas in obstructive sleep apnea (OSA) induce intermittent hypercapnia and hypoxia, eventually contributing to excessive uric acid production. This study aimed to evaluate the association between hyperuricemia and OSA in the general population via analysis of the eighth KNHANES dataset (2019-2021). OSA risk was identified via the STOP-Bang questionnaire, with a score ≥3 indicating high risk. Among 11,981 total participants, 4572 (38.2%) had a high OSA risk. Participants with a high OSA risk had higher uric acid levels compared to those with a low risk (5.5 ± 1.4 mg/dL vs. 4.8 ± 1.2 mg/dL, p < 0.001). Serum uric acid levels were positively correlated with STOP-Bang score (r: 0.317, p < 0.001). Multivariate analysis revealed that hyperuricemia was associated with a high OSA risk after adjusting for confounders (odds ratio: 1.30, 95%CI: 1.11-1.53, p = 0.001). Therefore, serum uric acid levels are significantly higher in those with a high OSA risk and correlate with the risk of OSA. Further, hyperuricemia is an independently associated risk factor for high OSA risk. More research is warranted to evaluate the long-term clinical outcomes of hyperuricemia in OSA and to determine whether treatment targeting hyperuricemia is effective in the clinical course 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.

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.

Mallampati score in patients with temporomandibular joint disorders: A pilot case-control study.

OBJECTIVES: Temporomandibular joint disorder (TMD) is defined as any functional abnormalities in different parts of the face and neck. The Mallampati index is an indicator for determining the extent of airway blockage. No study has examined the relationship between TMD and Mallampati score. Most studies have investigated the relationship between temporomandibular joint problems and sleep problems. This pilot study aimed to assess the Mallampati index scores among TMD patients. MATERIAL AND METHODS: Eighty-four people were divided into the case (based on RDC/TMD) and control groups. Demographic information, neck circumference, tongue size, Mallampati score, and other variables were asked of people. STOP-BANG and Pittsburgh Sleep Quality Index (PSQI) were also completed for each patient. Data were analyzed with Chi-square, Fisher's exact, and Mann-Whitney tests. RESULTS: The Mallampati and PSQI questionnaire scores in the case group were significantly higher than those in the control group (p < 0.001). The results showed that larger tongue and neck circumference patients had a higher Mallampati score. Pearson correlation coefficient showed that the Mallampati score had a direct and significant relationship with body mass index and PSQI (p < 0.001). CONCLUSIONS: The results of this study show that Mallampati scores were significantly higher among patients with TMD than among healthy individuals.

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.

Correlation of morning dry mouth with clinical features of OSA in a community population: a cross-sectional study.

OBJECTIVES: Morning dry mouth, commonly seen in Obstructive Sleep Apnea (OSA) patients, is absent in current OSA screening tools. This study evaluated the link between morning dry mouth and OSA's clinical symptoms and complications, aiming to determine its viability as a screening indicator. METHODS: This research analyses baseline data from a prospective cohort study (the PIFCOPD study). Demographic information, medical history, and the presence of morning dry mouth symptoms were collected. The STOP-Bang questionnaire was performed for OSA screening. Logistic regression analyses were employed to establish the correlations between morning dry mouth and the clinical symptoms and comorbidities of OSA. RESULT: 1291 participants (62.1±7.5 years; 501 males, 790 females) were included, of which 416 reported morning dry mouth (32.2%). 42.6% in the high-risk OSA group and 22.1% in the low-risk group reported morning dry mouth. Individuals with morning dry mouth also showed higher STOP-Bang scores (3.3±1.6 vs. 2.3±1.4, P<0.01). Significant associations were found between morning dry mouth and loud snoring, observed sleep apnea, daytime fatigue, and hyperlipidemia (P<0.01), but not with alcohol consumption, tea consumption, diabetes, or hypertension. CONCLUSION: Morning dry mouth is associated with increased OSA risk and its clinical signs, suggesting its potential as an OSA screening symptom. CLINICAL TRIAL REGISTRATION: This study has been registered at www.ClinicalTrials.gov (registration identifier: NCT03532893) on 21 May 2018.

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.

Predictive value of modified STOP-BANG questionnaire in painless gastroscopy for hypoxemia / 中国现代医生

@#Objective To explore predictive value of modified STOP-BANG questionnaire(MSBQ)for hypoxemia during painless gastroscopy.Methods A total of 300 patients were selected as the study subjects who underwent painless gastroscopy in Zhejiang Cancer Hospital from October to December 2021.The MSBQ and STOP-BANG questionnaire(SBQ)were used for assessment before the examination,and patients were divided into high risk group(total score≥3 points)and low risk group(total score<3 points)according to their scores.The incidence of hypoxemia in high risk group and low risk group of the two scales was observed.The predictive value of MSBQ and SBQ for the risk of hypoxemia during painless gastroscopy was evaluated by receiver operating characteristic(ROC)curve.Results The incidence of hypoxemia in high risk group was significantly higher than that in low risk group(P<0.05).The sensitivity of MSBQ and SBQ to predict the occurrence of hypoxemia in painless gastroscopy was 81.01%and 83.54%,the specificity was 78.28%and 66.06%,and the area under the curve was 0.81 and 0.79,respectively.The prediction efficiency of MSBQ was better.Conclusion MSBQ has a high predictive value for the risk of hypoxemia in painless gastroscopy.