Význam screeningových dotazníků v detekci závažnosti obstrukční spánkové apnoe

Abstract

ntroduction: The aim of this study is to compare the importance of screening questionnaires and risk factors in detecting the severity of obstructive sleep apnea (OSA). Methods: The study included 47 patients with suspected OSA. The patients completed 5 screening questionnaires – the Epworth Sleepiness Scale (ESS), the STOP BANG questionnaire, the STOP questionnaire, the Berlin questionnaire (BQ) and the Pittsburgh Sleep Quality Index (PSQI). Subsequently, they were examined by the limited polygraphy. AHI (number of apneas/ hypopneas per 1 hour), t90 desaturation (percentage of sleep time spent in desaturations below 90%) and ODI (number of desaturations ≥ 3% within 1 hour) were compared with questionnaire scores and selected risk factors for OSA (BMI, male gender, hypertension, age, neck circumference, abdominal circumference and abdominal/ hip circumference ratio). Results: The achieved score of any of the monitored questionnaires does not correlate with the value of AHI. BQ, STOP and STOP BANG questionnaires have the relatively highest sensitivity for OSA detection, while the sensitivity of PSQI and ESS is low. The correlation of the ESS, STOP BANG and BQ scores with the t90 desaturation, as well as the ESS and STOP BANG scores with the ODI is statistically signifi cant. The relationship of any of the selected risk factors with the AHI value has not been demonstrated. Desaturation values of t90 and ODI correlated best with BMI, neck circumference and abdominal/ hip circumference ratio. Conclusion: None of the monitored questionnaires is suitable for determining the severity of OSA, it is always necessary to perform a polygraphic or polysomnographic examination of sleep. BQ and STOPBANG are relatively most suitable for OSA screening. They both have high sensitivity and, at the same time, their score correlates with the value of nocturnal hypoxemia. Parameters measuring nocturnal hypoxemia (t90 desaturation, ODI) correlate better with risk factors than AHI. The most important parameters associated with hypoxemia are BMI, neck circumference and abdominal/ hip circumference ratio and it is appropriate to include them in the screening for OSA. Keywords: obstructive sleep apnea – Berlin questionnaire – STOP-Bang questionnaire – STOP questionnaire – Epworth sleepiness scale – Pittsburgh Sleep Quality Index