title: Predicting sleep disordered breathing in outpatients with suspected OSA.
abstract: OBJECTIVE
  To validate the utilities of Berlin, STOP and STOP-BANG Questionnaires, other patient characteristics, comorbidities, Epworth Sleepiness Scale (ESS), fractional exhaled nitric oxide (FENO) and blood markers for the prediction of sleep disordered breathing (SDB) on limited polygraphy.
  
  
  METHODS
  North Glasgow Sleep Service (a tertiary referral centre).
  
  
  METHODS
  129 consecutive patients, aged ≥16 years, referred to the sleep clinic for assessment of possible obstructive sleep apnoea.
  
  
  METHODS
  We selected cut-points of apnoea hypopnoea index (AHI) of ≥5 and ≥15/h from their home polygraphy and determined associations of these with individual symptoms, questionnaire scores and other results. Receiver operating characteristic analysis and univariate and multivariate logistic regression were used to explore these.
  
  
  METHODS
  Primary: The utility of STOP, STOP-BANG and Berlin Questionnaires for prediction of SDB. Secondary: The utility of other measures for prediction of SDB.
  
  
  RESULTS
  AHI was ≥5 in 97 patients and ≥15 in 56 patients. STOP and STOP-BANG scores were associated with both AHI cut-points but results with ESS and Berlin Questionnaire scores were negative. STOP-BANG had a negative predictive value 1.00 (0.77-1.00) for an AHI ≥15 with a score ≥3 predicting AHI ≥5 with sensitivity 0.93 (95% CI 0.84 to 0.98) and accuracy 79%, while a score ≥6 predicted AHI ≥15 with specificity 0.78 (0.65 to 0.88) and accuracy 72%. Neck circumference ≥17 inch and presence of witnessed apnoeas were independent predictors of SDB.
  
  
  CONCLUSIONS
  STOP and STOP-BANG Questionnaires have utility for the prediction of SDB in the sleep clinic population. Modification of the STOP-BANG Questionnaire merits further study in this and other patient groups.
authors.affiliation: North Glasgow Sleep Service, Gartnavel General Hospital and Glasgow Royal Infirmary, Glasgow, UK.
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Cowan
authors.forename: Gwen
authors.initials: G
authors.lastname: Allardice
authors.forename: Duncan
authors.initials: D
authors.lastname: Macfarlane
authors.forename: Darren
authors.initials: D
authors.lastname: Ramsay
authors.forename: Heather
authors.initials: H
authors.lastname: Ambler
authors.forename: Stephen
authors.initials: S
authors.lastname: Banham
authors.forename: Eric
authors.initials: E
authors.lastname: Livingston
authors.forename: Christopher
authors.initials: C
authors.lastname: Carlin
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods; D010045:Outpatients; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012606:Scotland; D012680:Sensitivity and Specificity; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000209:etiology*; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis*; D011795:Surveys and Questionnaires
keywords: SLEEP MEDICINE
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