A new sensitive and accurate model to predict moderate to severe obstructive sleep apnea in patients with obesity

Abstract

Obstructive sleep apnea (OSA) has a high prevalence in patients with obesity. Only patients with clinical symptoms of OSA are admitted to polysomnography; however, many patients with OSA are asymptomatic. We aimed to create and validate a population-based risk score that predicts the severity of OSA in patients with obesity. We here report the cross-sectional analysis at baseline of an ongoing study investigating the long-term effect of bariatric surgery on OSA. One-hundred sixty-one patients of the Obesity Center of the Catholic University Hospital in Rome, Italy were included in the study. The patients underwent overnight cardiorespiratory monitoring, blood chemistry analyses, hepatic ultrasound, and anthropometric measurements. The patients were divided into 2 groups according OSA severity assessed by the apnea-hypopnea index (AHI): AHI < 15 = no or mild and AHI ≥ 15 moderate to severe OSA. A statistical prediction model was created and validated. C statistics was used to evaluate the discrimination performance of the model. The prevalence of OSA was 96.3% with 74.5% of the subjects having moderate/severe OSA. Sex, body mass index, diabetes, and age were included in the final prediction model that had excellent discrimination ability (C statistics equals to 83%). An OSA risk chart score for clinical use was created. Patients with severe obesity are at a very high risk for moderate or severe OSA in particular if they are men, older, more obese, and/or with type 2 diabetes. The OSA risk chart can be useful for general practitioners and patients as well as for bariatric surgeons to select patients with high risk of moderate to severe OSA for further polysomnography.

The Prevalence and Predictors of Obstructive Sleep Apnea in Chinese Bariatric Surgery Candidates: A Single-Center Study

“…In a study by In the present study, the prediction model showed that increasing age, BMI and neck circumference together with presence of habitual snoring and male sex were identified as independent risk factors for OSA. Our results like previous reports showed that age was also a predictor of the presence of OSA in bariatric surgery population [35].…”

The association between shift work and possible obstructive sleep apnea: a systematic review and meta-analysis

“…The risk factors for OSA include obesity (Ahlin et al 2019;Peppard et al 2000), family history of sleep apnea (Redline et al 1995), and allergy (Calais et al 2016;Jiang et al 2016). There have been a few studies on work-related factors that affect OSA.…”

Simple and Unbiased OSA Prescreening: Introduction of a New Morphologic OSA Prediction Score

“…), did not differentiate OSA severity, and can be less practical and of limited statistical accuracy. [22][23][24][25][26][27][28] Given the existing evidence, a recent review on OSA prescreening tools for the US Preventive Services Task Forces concluded that the accuracy and clinical utility of current screening tools is not sufficient. 15 Thus, to identify patients at risk in a timely and cost-efficient manner, a well-performing early screening step in the diagnostic process is needed.…”