Screening for obstructive sleep apnea: comparing the American Academy of Sleep Medicine proposed criteria with the STOP-Bang, NoSAS, and GOAL instruments.

Autor: Duarte RLM; SleepLab, Laboratório de Estudo dos Distúrbios do Sono, Centro Médico BarraShopping, Rio de Janeiro, Brazil.; Instituto de Doenças do Tórax, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil., Magalhães-da-Silveira FJ; SleepLab, Laboratório de Estudo dos Distúrbios do Sono, Centro Médico BarraShopping, Rio de Janeiro, Brazil., Gozal D; Department of Child Health, University of Missouri School of Medicine, Columbia, Missouri.
Jazyk: angličtina
Zdroj: Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine [J Clin Sleep Med] 2023 Jul 01; Vol. 19 (7), pp. 1239-1246.
DOI: 10.5664/jcsm.10546
Abstrakt: Study Objectives: We evaluated the performance of the 2017 American Academy of Sleep Medicine criteria (AASM 2017 ) in screening obstructive sleep apnea (OSA) and compared them with 3 other validated instruments: NoSAS score, STOP-Bang, and GOAL questionnaires.
Methods: From July 2019 to December 2021, 4,499 adults undergoing overnight polysomnography were included. The AASM 2017 instrument considers an increased high risk for moderate-to-severe OSA in the presence of excessive daytime sleepiness and at least 2 of the following 3 criteria: loud snoring; observed apnea, gasping, or choking; and hypertension. OSA severity was based on polysomnography-derived apnea-hypopnea index cutoffs: 5.0 events/h, 15.0 events/h, and 30.0 events/h. Predictive performance was evaluated by the area under the curve and contingency tables.
Results: When screening for any OSA severity, AASM 2017 displayed a sensitivity of 31.0-40.6% and a specificity of 80.8-89.6%. For all apnea-hypopnea index thresholds, AASM 2017 , unlike the GOAL, STOP-Bang, and NoSAS, exhibited superior specificity but markedly lower sensitivity. GOAL, STOP-Bang, and NoSAS, but not AASM 2017 criteria, emerged as an adequate screening tool for any OSA severity (all areas under the curve > 0.7) and performed significantly better than AASM 2017 in predicting any OSA severity (all P < .001). For all severity OSA levels, GOAL, STOP-Bang, and NoSAS displayed similar performance when compared to each other (all P > .05).
Conclusions: GOAL, STOP-Bang, and NoSAS instruments, but not AASM 2017 criteria, emerge as useful OSA screening tools in a large referral single-center clinical cohort.
Citation: Duarte RLM, Magalhães-da-Silveira FJ, Gozal D. Screening for obstructive sleep apnea: comparing the American Academy of Sleep Medicine proposed criteria with the STOP-Bang, NoSAS, and GOAL instruments. J Clin Sleep Med . 2023;19(7):1239-1246.
(© 2023 American Academy of Sleep Medicine.)
Databáze: MEDLINE
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