0710 Validation of the Predictive Utility of the Multivariable Apnea Index for Obstructive Sleep Apnea in Women

Abstract

Abstract Introduction The Multivariable Apnea Prediction (MAP) index is a commonly used screening tool for obstructive sleep apnea (OSA). Previous analyses have demonstrated higher sensitivity of the MAP in predicting OSA in men versus women and in post-menopausal versus pre-menopausal women with type 2 diabetes (T2DM) and an apnea-hypopnea index (AHI) ≥10. The purpose of this secondary analysis was to validate previous findings by comparing women with and without T2DM across all categories of OSA severity including mild (AHI ≥5). Methods The sample (N=386) was comprised of participants from the Diabetes Sleep Treatment Trial who were recruited because of risk for OSA with T2DM (n=279), and the EMPOWER study which examined triggers for lapses or relapse after intentional weight loss in overweight but otherwise healthy participants (n=115). AHI was assessed by in-home sleep study, ApneaLink Plus®. Descriptive statistics and binomial logistic regression and receiver operating characteristic analyses were conducted to evaluate classification of OSA diagnosis, defined as AHI ≥5 or ≥10, by MAP between sexes and by menopause status. Results Participants were middle aged (mean 54.09 years + 10.63), obese (mean BMI of 34.79 + 6.52 kg/m2), primarily female (67%), and white (64%). Compared to men, women were younger (52.99 years + 10.15 vs. 56.26 years + 11.25, p=0.004) and had a lower AHI (9.10 + 18.94 vs. 17.25 + 18.94, p<0.001). No significant differences, except for age, were noted between pre- and post-menopausal women. Sensitivity of MAP on OSA diagnosis was higher for men than women (AHI ≥5: 94.7% vs. 76%; AHI ≥10: 84.2% vs 29.6%). Sensitivity of MAP on OSA diagnosis was lower for pre-menopausal than post-menopausal women using AHI ≥5 (74.0% vs. 98.8%) and AHI ≥10 (19.0% vs. 32.1%). Conclusion This validation study corroborates previous findings that the MAP index was better at identifying OSA in men than women, and in post- versus pre-menopausal women using AHI values across all categories of OSA severity. Improved screening methods are needed to detect women at high risk for OSA. Support (If Any) This study was funded by the National Institutes of Health (R01-DK090628, R01-HL107370).