| Objective:In the condition of considering the results of polysomnography(PSG) monitored in the laboratory as the diagnostic standard for obstructive sleep apnea hypopnea syndrome(OSAHS),we evaluated and compared the diagnostic accuracy of the STOP-Bang questionnaire(SBQ) and CMS50 F to the different severity of OSAHS respectively. At the same time, we also explored the CMS50 F whether could monitor sleeping at home. And whether it could enhance the diagnostic accuracy of CMS50 F when we combined the score of the SBQ.Methods : In this study, the patients suspected OSAHS in sleep clinic were consecutively recruited for the study. All subjects filled in the SBQ.Then they were underwent simultaneous nocturnal PSG and CMS50 F in the sleeping laboratory. The subjects were introduced the instructions of CMS50 F in detail, and then they took it back to home to conduct the three consecutive nights sleep monitoring.Results: There were 128 subjects completed all the process, so we analyzed those data. 1.There was a significant correlation between the score of SBQ and the apnea hypopnea index(AHI) of PSG(r=0.826,P< 0.05). There were statistic differences in body mass index(BMI), neck circumference, Lowest oxygen saturation(LSa O2) and AHI between the OSAHS at low risk and those at high risk. We divided the subjects into snoring, mild OSAHS group, moderate and severe OSAHS group according to AHI. Then we compared the score of SBQ in each group, and found that except the difference between simple snoring group and mild OSAHS, other groups were all significantly different. The sensitivities of the SBQ with AHI?5/h,AHI?15/h, AHI?30/h as cut-offs were 78.3%, 91.4% and 85.7%, and the specificities were 92.3%,82.8% and 96.6%,respectively. 2.When sleep monitoring were carried out simultaneously in the laboratory, the CMS50F-ODI3 was smaller than the PSG–AHI in the severe OSAHS patients, but there was no statistic difference in other groups. And there was a significant correlation between CMS50F-ODI3 and PSG-AHI(r=0.916,P<0.05). The area under the receiver operating characteristic curve(AUC) of CMS50 F for different degrees ofOSAHS could more than 0.9. 3.When monitoring carried at home, the AUC for CMS50F-ODI3 could reach more than 0.9 no matter recorded over 3 nights or after the first night, and there was no significantly different from each other. But when recorded across 3 nights,the rate of data loss from 8.6% down to 0, P <0.05. 4. When sleep monitoring were carried at home for one night, the AUC of CMS50 F for different degrees of OSAHS were higher than SBQ, P <0.05. 5. Combined the SBQ with the results of CMS50 F monitored at home in the first night, which was we defined OSAHS as meeting the SBQ score?4 points and CMS50F-ODI3?6 times / h at the same time. The sensitivity was 78.3%, it was smaller than CMS50 F, and its specificity was not larger than CMS50 F.If we defined the OSAHS as meeting the SBQ score?4 points or CMS50F-ODI3?6 times / h, its sensitivity and specificity were 97.4% and 92.3%. Its specificity was smaller than CMS50 F, and the sensitivity was also not larger than CMS50 F.Conclusions:1. SBQ is highly efficient for screening OSAHS, its sensitivity and specificity can achieve high level, and it also can predict the severity of OSAHS. 2. CMS50 F is an ideal screening tool for OSAHS, its diagnostic accuracy can reach high level for different severity OSAHS, and its diagnostic accuracy is superior to SBQ. 3. CMS50 F can achieve monitoring sleep at home, and it can reach a considerable degree of accuracy with the synchronous detection in laboratory. 4. For CMS50 F, increasing the number of monitoring sleep can increase the adequacy of the data, but it can not increase the diagnostic accuracy. So if the patients highly suspected with OSAHS do not exist the oxygen saturation(Sa O2) reduction, we should refer them to a sleep center for further PSG monitoring. 5.It can not increase the diagnosis accuracy of CMS50 F for OSAHS when we combine the score of SBQ to it. |
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