Prioritization of patients with suspected severe obstructive sleep apnoea: Epworth sleepiness scale, stop bang and measuring upper airway resistance.

INTRODUCTION

Obstructive sleep apnoea (OSA) is a major public health concern, and its prevalence leads to increased burden for health resources. While patients are required to undergo sleep studies, clinicians aim to early identification of high-risk individuals for improved predicting and management. We hypothesized that measuring upper airway resistance (UAR) could assist clinicians in selecting individuals at high risk for OSA. The purpose of this study was to quantify the impact of UAR measurement as a tool to stratify risk.

METHODS

This observational cross-sectional study consecutively included subjects suspected of having OSA. Two groups were defined: moderate/severe OSA (AHI ≥ 15/h) and mild/non-OSA (AHI < 15). Based on clinically validated scores, two risk categories were established: High-Risk group and Low-Risk group. Upper airway collapsibility (UAC) was assessed by measuring UAR using the obturation method. The predictive ability of UAC for the presence of OSA was estimated.

RESULTS

428 patients (54 ± 12 years old, 61% males) were included, 323 (75%) subjects in the High-Risk group. 281 (65%) had moderate-severe OSA, and 79 (24%) had UAC. Classification based on clinical scores showed a sensitivity of 80% and specificity of 33% for detecting moderate/severe OSA. When UAR measurement was added to the high-risk group, specificity increased to 81%.

CONCLUSION

Adding UAR to clinical scores in the High-Risk group improves specificity and helps clinicians identify individuals at higher risk for OSA earlier.