Screening for obstructive sleep apnea syndrome in patients with type 2 diabetes mellitus: a prospective study on sensitivity of Berlin and STOP-Bang questionnaires
Language English Country Netherlands Media print-electronic
Document type Evaluation Study, Journal Article
PubMed
27613528
DOI
10.1016/j.sleep.2016.07.009
PII: S1389-9457(16)30113-7
Knihovny.cz E-resources
- Keywords
- Berlin questionnaire, Cardiovascular risk factors, Diabetes, Obstructive sleep apnea, STOP-Bang questionnaire, Screening,
- MeSH
- Analysis of Variance MeSH
- Diabetes Mellitus, Type 2 * complications mortality MeSH
- Comorbidity MeSH
- Middle Aged MeSH
- Humans MeSH
- Sleep Apnea, Obstructive classification complications diagnosis MeSH
- Mass Screening methods MeSH
- Polysomnography methods MeSH
- Prospective Studies MeSH
- Surveys and Questionnaires standards MeSH
- Risk Factors MeSH
- Aged MeSH
- Sensitivity and Specificity MeSH
- Sex Factors MeSH
- Severity of Illness Index MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Evaluation Study MeSH
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.
Neurology and Sleep Laboratory INSPAMED s r o Kubelikova 46 Prague Czech Republic
Sleep Medicine Department National Institute of Mental Health Topolová 748 Klecany Czech Republic
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