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CC BY-NC-ND 4.0 · Sleep Sci
DOI: 10.1055/s-0044-1782167
Original Article

Crossectional Study on the Performance of Screening Questionnaires for Prediction of Moderate to Severe Obstructive Sleep Apnea in Women

María Belén Ginetti 
Sleep and Ventilation Unit, Hospital Britanico, Buenos Aires, Buenos Aires City, Argentina
,
Julieta Franzoy
Sleep and Ventilation Unit, Hospital Britanico, Buenos Aires, Buenos Aires City, Argentina
,
Marcella Perri
Sleep and Ventilation Unit, Hospital Britanico, Buenos Aires, Buenos Aires City, Argentina
,
Magali Blanco
Sleep and Ventilation Unit, Hospital Britanico, Buenos Aires, Buenos Aires City, Argentina
,
Glenda Ernst
Sleep and Ventilation Unit, Hospital Britanico, Buenos Aires, Buenos Aires City, Argentina
,
Alejandro Salvado
Sleep and Ventilation Unit, Hospital Britanico, Buenos Aires, Buenos Aires City, Argentina
,
Eduardo Enrique Borsini 
Sleep and Ventilation Unit, Hospital Britanico, Buenos Aires, Buenos Aires City, Argentina
› Author Affiliations Funding Source The author(s) received no financial support for the research.
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Abstract

Introduction The clinical manifestations of obstructive sleep apnea (OSA) are different between genders. Though there are several screening questionnaires for OSA, their performance in females is not fully understood, as women have been historically underrepresented in research studies.

Objective To assess the performance of screening questionnaires and their capacity to identify a moderate to severe apnea-hypopnea index (AHI) in women.

Materials and Methods The Epworth sleep scale (ESS), Berlin questionnaire, and STOP-BANG questionnaire (SBQ) were correlated with AHI. Also, the sensitivity (S), specificity (Sp), and area under the receiver operating characteristic (AUC-ROC) curve were calculated for each questionnaire and combinations thereof. Multiple regression models were used to identify ≥15 ev/h AHI.

Results Our study included 5,344 patients: 1978 women (37.1%) aged 55.06 ± 14 years with body mass index (BMI): 32.6 ± 8.30 kg/m2, ESS: 7.69 ± 5.2 points, and high-risk Berlin score: 87.25%. An AHI ≥15 ev/h was found in 30.4% of women. In terms of the capacity to identify an ≥15 ev/h AHI in women, the AUC-ROC of ESS >10 and high-risk Berlin was 0.53 and 0.58, respectively. Three components of SBQ in any combination showed: a S of 65.1% (95% CI: 61.2–68.9), a Sp: 61.5% (95% CI: 58.9–64.1), with the AUC-ROC: 0.67.

Conclusions Questionnaires perform differently in women. Therefore, it is necessary to take a gender-specific approach. The SBQ showed a higher discriminative power and more specificity than the ESS and the Berlin questionnaire. The best performance was obtained with any combination of 3 SBQ components. Age, BMI, neck circumference, and hypertension were the strongest predictors.

Keywords

sleep apnea syndrome - respiratory polygraphy - surveys and questionnaires


Publication History

Received: 25 April 2023

Accepted: 20 October 2023

Article published online:
09 April 2024

© 2024. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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