Is subjective sleep evaluation a good predictor for obstructive sleep apnea?

Cárita De Moura Laranjeira,Eline Rozária Ferreira Barbosa,Marcelo Fouad Rabahi

doi:10.6061/clinics/2018/e355

Abstract

OBJECTIVE:To compare subjective sleep evaluation obtained using four questionnaires with polysomnography results for individuals with and without obstructive sleep apnea.METHODS:Observational and analytical study in which individuals underwent polysomnography were studied retrospectively to investigate sleep disorders. We compared subjective data from a research database used to predict obstructive sleep apnea based on the STOP-BANG questionnaire, evaluation of excessive daytime sleepiness (Epworth Sleepiness Scale), sleep quality questionnaire (Mini Sleep Questionnaire) and Post-Sleep Data Collection Instrument with the self-reported total sleep time and sleep-onset latency for subjects with and without obstructive sleep apnea.RESULTS:The STOP-BANG questionnaire was a good predictor for the diagnosis of obstructive sleep apnea. However, the other instruments did not show a significant difference between healthy and sick individuals. Patients' perceptions of their sleep onset time were significantly lower than the polysomnographic data, but this difference remained for both subjects with and without obstructive sleep apnea. No difference was found between the subjective duration of sleep and the total sleep time assessed by polysomnography in either the healthy subjects or the patients.CONCLUSION:Except for the STOP-BANG questionnaire, subjective evaluation of sleepiness, sleep quality, perception of onset, and total sleep time are not important parameters for the diagnosis of obstructive sleep apnea, which reinforces the need for an active search for better management of these patients.

Highlights

Sleep is a complex behavioral state involving a reversible reduction of perception and relative unresponsiveness to the environment [1]
The main finding of this study is that subjective instruments for the detection of sleep disorders do not differentiate between sick and healthy individuals to predict Obstructive sleep apnea (OSA), with the exception of STOP-BANG
The perception of sleep onset and its total duration did not help differentiate between the presence and absence of OSA compared to the polysomnographic data

Summary

OBJECTIVE

OSA: obstructive sleep apnea; SD: standard deviation; BMI: body mass index; MSQ: Mini Sleep Questionnaire; PSG: polysomnography; ESS: Epworth Sleepiness Scale; PSDCI: Post-Sleep Data Collection Instrument; + Spearman Correlation. A positive correlation was found between the onset of sleep and sleep latency in women (po0.001) and adults (p=0.001). Patients with obstructive sleep apnea had a negative correlation between sleep onset and latency (r=-0.29 and po0.001). Wilcoxon’s non-parametric test (Figure 3) showed that the apneic patients perceived sleep onset as significantly greater than the objective data (overestimating latency), (po0.001). A positive correlation in the amount of perceived sleep time in relation to the total sleep time was found in all groups (po0.001 and r=0.31). Wilcoxon’s nonparametric test (Figure 4) showed that this difference was not significant in the non-apneic patients and in the participants with an AHI45 (p=0.57 and p=0.26, respectively) when the sleep perception was compared with the objective data. The relationship of arousals with the awakening perception was not significant

’ INTRODUCTION

’ METHODS

’ RESULTS

’ DISCUSSION

’ REFERENCES