Using the STOPBANG questionnaire and other pre-test probability tools to predict OSA in younger, thinner patients referred to a sleep medicine clinic

McMahon, Michael; Sheikh, Karen; Andrada, Teotimo; Holley, Aaron B.

doi:10.1007/s11325-017-1498-1

Cited by 14 publications

(8 citation statements)

References 43 publications

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“…The absence of association on CPET despite the dramatic difference in AHI between those with and without OSA (32.7 versus 5.8 events/h) casts doubt on a relationship between OSA and exercise in these patients. They also found no difference in STOP-BANG scores, consistent with data from our sleep center, 15 or Epworth Sleepiness Scale (ESS) scores, despite the fact that ESS was significantly elevated in both groups. So in this paper, it does not seem that an OSA diagnosis (in the severe range) is related to exercise physiology or sleep-related symptoms.…”

supporting

confidence: 78%

“…Active duty service members with sleep complaints typically have mild OSA, 15,16 which is poorly correlated with health outcomes and symptoms, 17 and comorbid disease (insomnia and insufficient sleep syndrome) 18 which could be the true driver of their symptoms. The Powell paper shows the AHI in this population is not related to sleep-related symptoms or exercise, so should we really expect benefits from normalizing it using positive airway pressure (PAP)?…”

Section: Osa Exercise and The Militarymentioning

confidence: 99%

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OSA, Exercise, and the Military

Holley

2019

Journal of Clinical Sleep Medicine

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confidence: 78%

Section: Osa Exercise and The Militarymentioning

confidence: 99%

OSA, Exercise, and the Military

Holley

2019

Journal of Clinical Sleep Medicine

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“…Soler et al confirmed that COPD patients with a BMI ≥ 25 kg/m 2 had a higher risk of OSA [ 29 ]. A South Korean clinical study showed that the accuracy of SBQ was not affected after removing the items ‘fatigue’ and ‘neck circumference’ [ 43 ], suggesting that the SBQ needs to be further optimized for Asian populations, including modifying or removing the scores for BMI and neck circumference for OSA screening in patients with COPD.…”

Section: Discussionmentioning

confidence: 99%

Predictors and outcomes of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in China

Zhang¹,

Lou³

et al. 2022

BMC Pulm Med

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Background “Overlap syndrome” refers to obstructive sleep apnea (OSA) combined with chronic obstructive pulmonary disease (COPD), and has poorer outcomes than either condition alone. We aimed to evaluate the prevalence and possible predictors of overlap syndrome and its association with clinical outcomes in patients with COPD. Methods We assessed the modified Medical Research Council dyspnea scale (mMRC), Epworth sleepiness scale (ESS), COPD assessment test (CAT), Hospital Anxiety and Depression Scale (HADS), Charlson Comorbidity Index (CCI), and STOP-Bang questionnaire (SBQ) and performed spirometry and full overnight polysomnography in all patients. An apnea–hypopnea index (AHI) ≥ 5 events per hour was considered to indicate OSA. Risk factors for OSA in COPD patients were identified by univariate and multivariate logistic regression analyses. Results A total of 556 patients (66%) had an AHI ≥ 5 events per hour. There were no significant differences in age, sex ratio, mMRC score, smoking index, number of acute exacerbations and hospitalizations in the last year, and prevalence of cor pulmonale between the two groups (all p > 0.05). Body mass index (BMI), neck circumference, CAT score, CCI, ESS, HADS, and SBQ scores, forced expiratory volume (FEV)1, FEV1% pred, FEV1/forced vital capacity ratio, and prevalence of hypertension, coronary heart disease, and diabetes were all significantly higher and the prevalence of severe COPD was significantly lower in the COPD-OSA group compared with the COPD group (p < 0.05). BMI, neck circumference, ESS, CAT, CCI, HADS, hypertension, and diabetes were independent risk factors for OSA in COPD patients (p < 0.05). SBQ could be used for OSA screening in patients with COPD. Patients with severe COPD had a lower risk of OSA compared with patients with mild or moderate COPD (β = − 0.459, odds ratio = 0.632, 95% confidence interval 0.401–0.997, p = 0.048). Conclusion Patients with overlap syndrome had a poorer quality of life, more daytime sleepiness, and a higher prevalence of hypertension and diabetes than patients with COPD alone. BMI, neck circumference, ESS, CAT, CCI, HADS, hypertension, and diabetes were independent risk factors for OSA in patients with COPD. The risk of OSA was lower in patients with severe, compared with mild or moderate COPD.

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“…42 Soler et al con rmed that COPD patients with a BMI ≥25 kg/m 2 had a higher risk of OSA. 29 A South Korean clinical study showed that the accuracy of SBQ was not affected after removing the items 'fatigue' and 'neck circumference', 43 suggesting that the SBQ needs to be further optimized for Asian populations, including modifying or removing the scores for BMI and neck circumference for OSA screening in patients with COPD.…”

Section: Discussionmentioning

confidence: 99%

Predictors and outcomes of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in China: a cross-sectional study

Zhang¹,

Bi²,

Lou³

et al. 2021

Preprint

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‘Overlap syndrome’ refers to obstructive sleep apnea (OSA) combined with chronic obstructive pulmonary disease (COPD), and has poorer outcomes than either condition alone. We aimed to evaluate the prevalence and possible predictors of overlap syndrome and its association with clinical outcomes in patients with COPD. We conducted a cross-sectional study in 842 patients with COPD. We assessed the modified Medical Research Council dyspnea scale (mMRC), Epworth sleepiness scale (ESS), COPD assessment test (CAT), Hospital Anxiety and Depression Scale (HADS), Charlson Comorbidity Index (CCI), and STOP-Bang questionnaire (SBQ) and performed spirometry and full overnight polysomnography in all patients. An apnea–hypopnea index (AHI) ≥ 5 events per hour was considered to indicate OSA. Participants were divided into a COPDOSA group with AHI ≥ 15 events per hour and a COPD group with AHI < 15 events per hour. Risk factors for OSA in COPD patients were identified by univariate and multivariate logistic regression analyses. A total of 556 patients (66%) had an AHI ≥ 5 events per hour. There were no significant differences in age, sex ratio, mMRC score, smoking index, number of acute exacerbations and hospitalizations in the last year, and prevalence of cor pulmonale between the two groups (all p > 0.05). Body mass index (BMI), neck circumference, CAT score, CCI, ESS, HADS, and SBQ scores, forced expiratory volume (FEV)1, FEV1%, FEV1/forced vital capacity ratio, and prevalence of hypertension, coronary heart disease, and diabetes were all significantly higher and the prevalence of severe COPD was significantly lower in the COPDOSA group compared with the COPD group (p < 0.05). BMI, neck circumference, ESS, CAT, CCI, HADS, hypertension, and diabetes were independent risk factors for OSA in COPD patients (p < 0.05). SBQ could be used for OSA screening in patients with COPD. Patients with severe COPD (FEV1% <50%) had a lower risk of OSA compared with patients with mild or moderate COPD (β=−0.459, odds ratio = 0.632, 95% confidence interval 0.401–0.997, p = 0.048). Conclusions Patients with overlap syndrome had a poorer quality of life, more daytime sleepiness, and a higher prevalence of hypertension and diabetes than patients with COPD alone. BMI, neck circumference, ESS, CAT, CCI, HADS, hypertension, and diabetes were independent risk factors for OSA in patients with COPD. The risk of OSA was lower in patients with severe, compared with mild or moderate COPD.

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Using the STOPBANG questionnaire and other pre-test probability tools to predict OSA in younger, thinner patients referred to a sleep medicine clinic

Abstract: In a younger, thinner population with predominantly mild-to-moderate OSA, the STOPBANG Score does not accurately predict the presence of obstructive sleep apnea.

Cited by 14 publications

References 43 publications

OSA, Exercise, and the Military

OSA, Exercise, and the Military

Predictors and outcomes of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in China

Predictors and outcomes of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in China: a cross-sectional study

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