<p>The Screening Value Of ESS, SACS, BQ, And SBQ On Obstructive Sleep Apnea In Patients With Chronic Obstructive Pulmonary Disease</p>

Abstract

Objective: To compare the performance of Epworth sleepiness scale (ESS), sleep apnea clinical score (SACS), Berlin questionnaire (BQ), and STOP-BANG questionnaire (SBQ) in screening for obstructive sleep apnea (OSA) in patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 431 patients were analyzed. All subjects completed lung function test, ESS, SACS, BQ, and SBQ survey and overnight polysomnography (PSG). According to lung function and PSG results, participants were divided into COPD with OSA group (OVS, AHI ≥5) and without OSA group (AHI <5). The value of ESS, SACS, BQ, and SBQ was compared in predicting OSA in patients with COPD by receiver-operating characteristic (ROC) curve statistics. Results: Of the 431 subjects, there were 96 cases in COPD without OSA group, and 335 cases in OVS group including 183, 96, and 56 cases of COPD combined with mild, moderate or severe OSA. In predicting different degrees of severity of OSA in patients with COPD, the value of ESS was poor with all the values of area under the curve (AUC) < 0.7. SACS and BQ had moderate predictive value in screening for severe OSA with the value of AUC of 0.750, 0.735 respectively. However, the SBQ performed best in predicting various degrees of OSA. For screening mild OSA (AHI ≥5), the ROC statistics recommended the cutoff score of SBQ >2 was considered high risk of OSA; the sensitivity, specificity, and AUC were 92.8%, 40.6%, and 0.723 respectively, the odds ratio (OR) was 2.161. When AHI ≥15, AUC for SBQ was 0.737. In predicting severe OSA (AHI ≥30), the ROC curve showed cutoff point, sensitivity, specificity, and AUC for SBQ was >4, 66.1%, 82.1%, and 0.824 respectively; the positive and negative likelihood ratio was 3.70, 0.41 separately, the OR was 2.977. Conclusion: SBQ performed better than ESS, SACS, and BQ in predicting OSA in patients with COPD.

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

“…Multiple regression analysis showed that patients with COPD and coexisting OSA had higher CAT, ESS, CCI, and SBQ scores compared with patients with COPD alone. These findings were in line with previous studies that showed positive relationships between OSA and CAT, ESS, CCI, and SBQ scores in patients with COPD [ 28 , 39 ]. This suggested that patients with COPD overlapping with OSA had more-severe clinical symptoms, more-limited daily activities, more complications, and poorer sleep quality and quality of life.…”

“…We found a correlation between COPD severity and OSA. Compared with patients with COPD alone, patients with COPD plus OSA had higher FEV 1 , FEV 1 % of predicted value, and FEV 1 /FVC, and a lower proportion of severe COPD [ 26 – 28 , 39 ]. The incidence of OSA increased with increasing airflow restriction in COPD patients with AHI < 5 events per hour, and decreased with increasing airflow restriction in COPD patients with AHI > 30 events per hour.…”

A Prediction Nomogram Combining Epworth Sleepiness Scale and Other Clinical Parameters to Predict Obstructive Sleep Apnea in Patients with Hypertension

“…In the present study, DCA, NRI, and IDI indicated that at a probability threshold of >42%, the nomogram was more clinically beneficial and could better predict OSA than the ESS. STOP-Bang was initially used to screen surgical patients [ 40 ], and its ability to predict mild, moderate, and severe OSA was higher than that of the sleep apnea clinical score, BQ, and ESS [ 41 ]. However, the AUC of OSA for all degrees of severity (0.72) was lower than that of our model [ 20 ].…”

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

“…These ndings were in line with previous studies that showed positive relationships between OSA and CAT, ESS, CCI, and SBQ scores in patients with COPD. 28,39 This suggested that patients with COPD overlapping with OSA had more-severe clinical symptoms, more-limited daily activities, more complications, and poorer sleep quality and quality of life. Although our ndings suggested that the SBQ could be used for OSA screening, hypertension and male sex were the main contributory factors, while BMI and neck circumference were less important.…”

“…Compared with patients with COPD alone, patients with COPD plus OSA had higher FEV 1 , FEV 1 % of predicted value, and FEV 1 /FVC, and a lower proportion of severe COPD. [26][27][28]39 The incidence of OSA increased with increasing air ow restriction in COPD patients with AHI <5 events per hour, and decreased with increasing air ow restriction in COPD patients with AHI >30 events per hour. Compared with patients with mild and moderate air ow restriction, the proportion of AHI <5 events per hour was higher and the proportion of AHI >30 events per hour was lower in patients with severe air ow restriction.…”