Citation Information :
Saxena M, Sah R, Gahlot T. Utility of Combining Epworth Sleepiness Scale, STOP-BANG and Perioperative Sleep Apnea Prediction Score for Predicting Absence of Obstructive Sleep Apnea. Indian Sleep Med 2018; 13 (4):62-66.
Aims and objective: To correlate and predict obstructive sleep apnea with the help of 3 sleep questionnaire-perioperative sleep apnea prediction score (PSAP), STOP-BANG, Epworth sleepiness scale score (ESS).
Materials and methods: Prospective study of 69 patients were subjected to 3 sleep questionnaire (PSAP, STOP-BANG, and ESS), then they all were subjected to polysomnography. Obstructive sleep apnea (OSA) was defined for AHI>15, and all these three questionnaires final score was correlated with apnea-hypopnea index (AHI), and their utility in predicting OSA was calculated (separately as well as when three questionnaire score taken together) using receiver operating characteristic (ROC) curves.
Results: Total 69 patients with the mean age of 50.29 ± 11.37 years, and male: female of 2:1 and mean body mass index (BMI) of 31.27 ± 7.253 kg/m2, mean AHI was calculated to be 19.63 ± 22. 49 and it significantly correlated with PSAP 4.52 ± 1.596 (r = 0.376, p = 0.001), STOP-BANG 4.493 ± 1.711 (r = 0.303, p = 0.011), ESS 13.00 ± 6.782 (r = 0.395, p = 0.001). PSAP (area under curve (AUC) = 0.761) had a better prediction for OSA than STOP-BANG (AUC = 0.697) and ESS (AUC = 0.669) according to Receiver operating curve. Cut off values for diagnosis of OSA from our data was calculated to be 4 for PSAP (sensitivity: 81% specificity: 59%), 4 for STOP-BANG (sensitivity: 65.4%, specificity: 60%) and 11 for ESS (sensitivity: 73.1%; specificity: 48.8%). Based on these cut off value 18 patients were found to be having all questionnaire positive of which 11 had OSA (AHI>15) and rest seven non-OSA. A total of 11 patients were all questionnaire negative of which 10 were non-OSA (AHI < 15). So when three questionnaires were combined to predict OSA their sensitivity was 91.66% and specificity was 58.8%, a positive predictive value of 61% and negative predictive value of 90.11%.
Conclusion: Perioperative sleep apnea prediction score (PSAP), STOP-BANG, ESS when taken together can be very helpful in screening for OSA and if all scores are negative it virtually rules out OSA.
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