Dados do Trabalho

Título

Analysis of tracking instruments for obstructive sleep apnea in different age groups

Introdução

Obstructive sleep apnea syndrome (OSA) is the most frequent sleep respiratory disorder. Type I polysomnography (PSG) is the gold standard exam to diagnose, but it is difficult to access and has a high cost. Therefore, other tracking instruments are important tools for clinical practice.

Objetivo

To analyze Berlin (BQ) and STOP-BANG (SBQ) questionnaires performances, as well as the Epworth sleep scale (ESE), in different age groups.

Métodos

This is a transversal study, with samples coming from the sleep clinic of the Hospital Universitário Gaffrée e Guinle, from February 2020 to January 2022. Subjects were interviewed with clinic epidemiologic data collection, including the three instruments and PSG. The sample were characterized into three age groups: 18 to 39 (G1), 40 to 59 (G2) and > 60 years (G3).

Resultados

The sample consisted of 321 subjects, whose 46% in the G2 and average age was 50 years. Females were the predominant gender (56%). OSA frequency was 79 %, with 25% considered mild, 24% moderate and 39% severe. The severe OSA was predominant in G2 and G3, 43% and 42% respectively. When compared to PSG, BQ and SBQ showed better performance in all age groups. Concerning G1, G2 and G3, the PSG was positive for OAS, respectively in 67%, 86% and 79%, while in BQ it was 67%, 82% and 70%, and in SBQ, 59%, 86% and 82%; the ESE was positive in 65%, 52% and 31%. In the analysis of the general sample, BQ and SBQ had the highest sensibilities, 81% and 86%, respectively, while ESE had the highest specificity, 66%. The predictive positive value of the three instruments were very similar, due to their OSA frequency. The ESE showed the lowest negative predicted value, 27%. SBQ had the highest likelihood and accuracy ratios, 1.80 and 79%, respectively. The ESE had the worst accuracy, 56%. Age group analysis showed that the BQ had the best performance in G2, with an accuracy of 78%; SBQ had similar accuracy in all age groups. The ESE had similar performance in G1 and G2, with lower sensibility and accuracy to G3, 37% and 48%, respectively.

Conclusões

In this sample, in a general way, BQ and SBQ showed better performances to OSA suspicion. In the age group analysis, SBQ stood out by showing similar performance for all groups, suggesting that it is a good instrument for application, regardless of age. BQ showed better performance to the intermediate range, while ESE was less satisfactory in the older subjects.

Palavras -chave

Sleep apnea; age; questionnaires; tracking instruments