Source:Sleep Medicine
Author(s): Katerina Westlake, Andrea Plihalova, Martin Pretl, Zuzana Lattova, Jan Polak
BackgroundObstructive sleep apnea (OSA) is highly prevalent in patients with Type 2 diabetes mellitus representing an additional risk factor for already increased cardiovascular mortality. As cardiovascular diseases are the main cause of death in this population, there is a need to identify patients with moderate to severe OSA indicated for treatment. We aimed to evaluate the performance of the Berlin, STOP and STOP-Bang screening questionnaires in a population of patients with Type 2 diabetes mellitus.Methods294 consecutive patients with Type 2 diabetes mellitus filled in the questionnaires and underwent overnight home sleep monitoring using a type IV sleep monitor.ResultsSevere, moderate and mild OSA was found in 31 (10%), 61 (21%) and 121 (41%) patients, respectively. The questionnaires showed a similar sensitivity and specificity for AHI ≥ 15: 0⋅69 and 0⋅50 for Berlin, 0⋅65 and 0⋅49 for STOP and 0⋅59 and 0⋅68 for STOP-Bang. However, the performance of the STOP-Bang questionnaire was different in men vs. women, sensitivity being 0⋅74 vs. 0⋅29 (p < 0⋅05) and specificity 0⋅56 vs. 0⋅82 (p < 0⋅05).ConclusionsEven the best-performing Berlin questionnaire failed to identify 31% of patients with moderate to severe OSA as being at high risk of OSA, thus preventing them from receiving a correct diagnosis and treatment. Considering that patients with Type 2 diabetes mellitus are at high risk of cardiovascular mortality and also have a high prevalence of moderate to severe OSA, we find screening based on the questionnaires suboptimal and suggest that OSA screening should be performed using home sleep monitoring devices.
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