A simplified model of screening questionnaire and home monitoring for obstructive sleep apnoea in primary care

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dc.contributor.authorChai-Coetzer, C.
dc.contributor.authorAntic, N.
dc.contributor.authorRowland, L.
dc.contributor.authorCatcheside, P.
dc.contributor.authorEsterman, A.
dc.contributor.authorReed, R.
dc.contributor.authorWilliams, H.
dc.contributor.authorDunn, S.
dc.contributor.authorMcEvoy, R.
dc.date.issued2011
dc.description.abstractBackground: To address the growing burden of disease and long waiting lists for sleep services, a simplified two-stage model was developed and validated for identifying obstructive sleep apnoea (OSA) in primary care using a screening questionnaire followed by home sleep monitoring. Methods: 157 patients aged 25–70 years attending their primary care physician for any reason at six primary care clinics in rural and metropolitan regions of South Australia participated. The first 79 patients formed the development group and the next 78 patients the validation group. A screening questionnaire was developed from factors identified from sleep surveys, demographic and anthropometric data to be predictive of moderate to severe OSA. Receiver operating characteristic (ROC) curve analysis was used to validate the two-channel ApneaLink device against full polysomnography. The diagnostic accuracy of the overall two-stage model was then evaluated. Results: Snoring, waist circumference, witnessed apnoeas and age were predictive of OSA and incorporated into a screening questionnaire (ROC area under curve (AUC) 0.84, 95% CI 0.75 to 0.94, p<0.001). ApneaLink oximetry with a 3% dip rate was highly predictive of OSA (AUC 0.96, 95% CI 0.91 to 1.0, p<0.001). The two-stage diagnostic model showed a sensitivity of 0.97 (95% CI 0.81 to 1.00) and specificity of 0.87 (95% CI 0.74 to 0.95) in the development group, and a sensitivity of 0.88 (95% CI 0.60 to 0.98) and specificity of 0.82 (95% CI 0.70 to 0.90) in the validation group. Conclusion: A two-stage model of screening questionnaire followed by home oximetry can accurately identify patients with OSA in primary care and has the potential to expedite care for patients with this common sleep disorder.
dc.description.statementofresponsibilityChing Li Chai-Coetzer, Nick A Antic, L Sharn Rowland, Peter G Catcheside, Adrian Esterman, Richard L Reed, Helena Williams, Sandra Dunn, R Doug McEvoy
dc.identifier.citationThorax, 2011; 66(3):213-219
dc.identifier.doi10.1136/thx.2010.152801
dc.identifier.issn0040-6376
dc.identifier.issn1468-3296
dc.identifier.orcidCatcheside, P. [0000-0002-9372-6788]
dc.identifier.orcidEsterman, A. [0000-0001-7324-9171]
dc.identifier.orcidMcEvoy, R. [0000-0002-5759-0094]
dc.identifier.urihttp://hdl.handle.net/2440/65679
dc.language.isoen
dc.publisherBritish Med Journal Publ Group
dc.rightsCopyright © 2011 BMJ Publishing Group Ltd & British Thoracic Society. All rights reserved.
dc.source.urihttps://doi.org/10.1136/thx.2010.152801
dc.subjectHumans
dc.subjectSleep Apnea, Obstructive
dc.subjectSnoring
dc.subjectMass Screening
dc.subjectAnthropometry
dc.subjectEpidemiologic Methods
dc.subjectAge Factors
dc.subjectDecision Support Techniques
dc.subjectAdult
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectHome Care Services
dc.subjectPrimary Health Care
dc.subjectSouth Australia
dc.subjectFemale
dc.subjectMale
dc.subjectWaist Circumference
dc.titleA simplified model of screening questionnaire and home monitoring for obstructive sleep apnoea in primary care
dc.typeJournal article
pubs.publication-statusPublished

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