title: Prediction of obstructive sleep apnea syndrome in a large Greek population.
abstract: OBJECTIVE
  We aimed to evaluate the predictive value of anthropometric measurements and self-reported symptoms of obstructive sleep apnea syndrome (OSAS) in a large number of not yet diagnosed or treated patients. Commonly used clinical indices were used to derive a prediction formula that could identify patients at low and high risk for OSAS.
  
  
  METHODS
  Two thousand six hundred ninety patients with suspected OSAS were enrolled. We obtained weight; height; neck, waist, and hip circumference; and a measure of subjective sleepiness (Epworth sleepiness scale--ESS) prior to diagnostic polysomnography. Excessive daytime sleepiness severity (EDS) was coded as follows: 0 for ESS ≤ 3 (normal), 1 for ESS score 4-9 (normal to mild sleepiness), 2 for score 10-16 (moderate to severe sleepiness), and 3 for score >16 (severe sleepiness). Multivariate linear and logistic regression analysis was used to identify independent predictors of apnea-hypopnea index (AHI) and derive a prediction formula.
  
  
  RESULTS
  Neck circumference (NC) in centimeters, body mass index (BMI) in kilograms per square meter, sleepiness as a code indicating EDS severity, and gender as a constant were significant predictors for AHI. The derived formula was: AHIpred = NC × 0.84 + EDS × 7.78 + BMI × 0.91 - [8.2 × gender constant (1 or 2) + 37]. The probability that this equation predicts AHI greater than 15 correctly was 78%.
  
  
  CONCLUSIONS
  Gender, BMI, NC, and sleepiness were significant clinical predictors of OSAS in Greek subjects. Such a prediction formula can play a role in prioritizing patients for PSG evaluation, diagnosis, and initiation of treatment.
authors.affiliation: Sleep Disorders Unit, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, Heraklion, Crete, Greece. izolthi@gmail.com
authors.forename: Izolde
authors.initials: I
authors.lastname: Bouloukaki
authors.forename: Fotis
authors.initials: F
authors.lastname: Kapsimalis
authors.forename: Charalampos
authors.initials: C
authors.lastname: Mermigkis
authors.forename: Meir
authors.initials: M
authors.lastname: Kryger
authors.forename: Nikos
authors.initials: N
authors.lastname: Tzanakis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Panagou
authors.forename: Violeta
authors.initials: V
authors.lastname: Moniaki
authors.forename: Eleni M
authors.initials: EM
authors.lastname: Vlachaki
authors.forename: Georgios
authors.initials: G
authors.lastname: Varouchakis
authors.forename: Nikolaos M
authors.initials: NM
authors.lastname: Siafakas
authors.forename: Sophia E
authors.initials: SE
authors.lastname: Schiza
mesh_terms: D000328:Adult; D000886:Anthropometry; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D005260:Female; D006115:Greece; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017286:Polysomnography; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*