A simplified model of screening questionnaire and home monitoring for obstructive sleep apnoea in primary care
Open Access
- 20 January 2011
- Vol. 66 (3), 213-219
- https://doi.org/10.1136/thx.2010.152801
Abstract
Background To address the growing burden of disease and long waiting lists for sleep services, a simplified two-stage model was developed and validated for identifying obstructive sleep apnoea (OSA) in primary care using a screening questionnaire followed by home sleep monitoring. Methods 157 patients aged 25–70 years attending their primary care physician for any reason at six primary care clinics in rural and metropolitan regions of South Australia participated. The first 79 patients formed the development group and the next 78 patients the validation group. A screening questionnaire was developed from factors identified from sleep surveys, demographic and anthropometric data to be predictive of moderate to severe OSA. Receiver operating characteristic (ROC) curve analysis was used to validate the two-channel ApneaLink device against full polysomnography. The diagnostic accuracy of the overall two-stage model was then evaluated. Results Snoring, waist circumference, witnessed apnoeas and age were predictive of OSA and incorporated into a screening questionnaire (ROC area under curve (AUC) 0.84, 95% CI 0.75 to 0.94, pConclusion A two-stage model of screening questionnaire followed by home oximetry can accurately identify patients with OSA in primary care and has the potential to expedite care for patients with this common sleep disorder.This publication has 35 references indexed in Scilit:
- Pathophysiology of Adult Obstructive Sleep ApneaProceedings of the American Thoracic Society, 2008
- Waist Circumference and Sleep Disordered BreathingThe Laryngoscope, 2008
- Prevalence of Overweight and Obesity in the United States, 1999-2004JAMA, 2006
- Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational studyThe Lancet, 2005
- Sleep {middle dot} 4: Sleepiness, cognitive function, and quality of life in obstructive sleep apnoea/hypopnoea syndromeThorax, 2004
- Towards Complete and Accurate Reporting of Studies of Diagnostic Accuracy: The STARD InitiativeClinical Chemistry, 2003
- Underdiagnosis of Sleep Apnea Syndrome in U.S. CommunitiesSleep and Breathing, 2002
- Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)JAMA, 2001
- Predictive value of clinical features for the obstructive sleep apnoea syndromeEuropean Respiratory Journal, 1996
- An Exploratory Technique for Investigating Large Quantities of Categorical DataJournal of the Royal Statistical Society Series C: Applied Statistics, 1980