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0446 Screening for Obstructive Sleep Apnea in the Young Adult Population

Sleep (New York, N.Y.), 2019-04, Vol.42 (Supplement_1), p.A179-A180 [Peer Reviewed Journal]

Sleep Research Society 2019. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com. ;ISSN: 0161-8105 ;EISSN: 1550-9109 ;DOI: 10.1093/sleep/zsz067.445

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  • Title:
    0446 Screening for Obstructive Sleep Apnea in the Young Adult Population
  • Author: Williams, Bradley ; Holland, Nicholas ; Mahakian, Charles
  • Subjects: Hypertension ; Population ; Sleep apnea ; Young adults
  • Is Part Of: Sleep (New York, N.Y.), 2019-04, Vol.42 (Supplement_1), p.A179-A180
  • Description: Introduction Existing obstructive sleep apnea (OSA) screens have been validated to detect moderate-to-severe OSA. Severe disease comorbidity focuses screens on a sensitive detection of moderate-to-severe OSA for urgent treatment. For the young adult population with predominantly mild-to-moderate OSA, we propose a screening strategy focused on the specific detection of all OSA to conserve healthcare costs. We applied the Berlin, STOPBANG, Four Variable and NAMES2 as well as pre-test probability (PTP) for symptoms of hypertension, elevated neck circumference and snoring in a cohort of sleep center patients 18-39 years of age with predominantly mild-to-moderate OSA. Methods Using data collected at the initial clinic encounter we calculated PTP for four PTP tools and four presenting symptoms. All patients had in lab polysomnography scored using the 2007 AASM criteria. We calculated sensitivity, specificity, positive predictive value (PPV), area under receiver-operator characteristic curves (AUROC) and the diagnostic odds ratios (DOR). Results There were 141 patients who had data available for analysis. The mean age and BMI were 30.8 ± 6.2 and 28.9 ± 5.6 respectively, and the mean Epworth Sleepiness Sore (ESS) was 12.0 ± 5.3. The mean AHI was 8.1 ± 14.4, and 56 patients (40%) had an AHI ≥ 5 and were considered positive for OSA. Of those with OSA, 63% had mild-to-moderate disease. For the Berlin, STOPBANG (positive at ≥ 3), Four Variable (positive at ≥ 9) and NAMES2 PTP tools, sensitivities ranged from 85.2-94.6%, specificities from 23.5-32.9%, PPV from 44.2-46.4%, AUROC from 0.59-0.61 and DOR from 2.6-5.4. The combined symptom set of snoring, hypertension (by self-report on STOPBANG) and elevated neck circumference (≥ 17 inches for men, ≥ 16 inches for women) resulted in 13% sensitivity, 99% specificity, 88% PPV, AUROC of 0.557 and DOR of 12. Conclusion In the young adult population with predominantly mild-to-moderate OSA, existing PTP tools perform with poor specificity, positive predictive value and diagnostic odds ratio. The combined symptom set of snoring, hypertension and elevated neck circumference, suggests high specificity and an improved DOR for OSA in the young adult population. Support (If Any)
  • Publisher: Westchester: Oxford University Press
  • Language: English
  • Identifier: ISSN: 0161-8105
    EISSN: 1550-9109
    DOI: 10.1093/sleep/zsz067.445
  • Source: ProQuest One Psychology
    Alma/SFX Local Collection
    ProQuest Central
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