Screening for obstructive sleep apnea syndrome in patients with type 2 diabetes mellitus: a prospective study on sensitivity of Berlin and STOP-Bang questionnaires

被引:31
作者
Westlake, Katerina [1 ,2 ]
Plihalova, Andrea [1 ,3 ]
Pretl, Martin [4 ]
Lattova, Zuzana [5 ]
Polak, Jan [1 ,3 ]
机构
[1] Vinohrady Teaching Hosp, Dept Internal Med 2, Srobarova 50, Prague, Czech Republic
[2] Diabetol Practice Diainmed Sro, Slunecna 2, Prague, Czech Republic
[3] Charles Univ Prague, Fac Med 3, Ctr Res Diabet Metab & Nutr, Ruska 87, Prague 10000 10, Czech Republic
[4] INSPAMED Sro, Neurol & Sleep Lab, Kubelikova 46, Prague, Czech Republic
[5] Natl Inst Mental Hlth, Sleep Med Dept, Topolova 748, Klecany, Czech Republic
关键词
Obstructive sleep apnea; Cardiovascular risk factors; Diabetes; Berlin questionnaire; STOP-Bang questionnaire; Screening; POSITIVE AIRWAY PRESSURE; CARDIOVASCULAR MORTALITY; RECORDING DEVICE; APNEALINK(TM); METAANALYSIS; VALIDATION; DIAGNOSIS; HYPOPNEA; COHORT; RISK;
D O I
10.1016/j.sleep.2016.07.009
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Obstructive sleep apnea (OSA) is highly prevalent in patients with Type 2 diabetes mellitus representing an additional risk factor for already increased cardiovascular mortality. As cardiovascular diseases are the main cause of death in this population, there is a need to identify patients with moderate to severe OSA indicated for treatment. We aimed to evaluate the performance of the Berlin, STOP, and STOP-Bang screening questionnaires in a population of patients with Type 2 diabetes mellitus. Methods: 294 consecutive patients with Type 2 diabetes mellitus filled in the questionnaires and underwent overnight home sleep monitoring using a type IV sleep monitor. Results: Severe, moderate, and mild OSA was found in 31 (10%), 61 (21%), and 121 (41%) patients, respectively. The questionnaires showed a similar sensitivity and specificity for AHI >= 15: 0.69 and 0.50 for Berlin, 0.65 and 0.49 for STOP, and 0.59 and 0.68 for STOP-Bang. However, the performance of the STOP Bang questionnaire was different in men vs. women, sensitivity being 0.74 vs. 0.29 (p < 0.05) and specificity 0.56 vs. 0.82 (p < 0.05). Conclusions: Even the best-performing Berlin questionnaire failed to identify 31% of patients with moderate to severe OSA as being at high risk of OSA, thus preventing them from receiving a correct diagnosis and treatment. Considering that patients with Type 2 diabetes mellitus are at high risk of cardiovascular mortality and also have a high prevalence of moderate to severe OSA, we find screening based on the questionnaires suboptimal and suggest that OSA screening should be performed using home sleep monitoring devices. (C) 2016 Elsevier B.V. All rights reserved.
引用
收藏
页码:71 / 76
页数:6
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