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Are the Epworth Sleepiness Scale and Stop-Bang model effective at predicting the severity of obstructive sleep apnoea (OSA); in particular OSA requiring treatment?

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A Letter to the Editor to this article was published on 21 September 2017

Abstract

Obstructive sleep apnoea (OSA) is a condition characterised by repetitive upper airway collapse during sleep. The condition carries a range of health sequelae that can prove fatal in cases with co-existing risk factors for the condition, such as obesity and hypertension. Utilisation of a high-performance screening tool for OSA is thus important. A retrospective audit using the ESS and Stop-Bang scores, alongside Apnoea–Hypopnea Index values, for patients who underwent polysomnography over 1 year. Multinomial logistic regression was used to compare the predictive abilities of ESS, SBM, and body mass index (BMI) for the patient outcome groups, “None” (No OSA), “Notreat” (OSA not requiring treatment) and “treat” (OSA requiring treatment). The influences of age, gender and BMI on outcome group were also assessed. 126 bariatric and 66 non-bariatric patients were included. Multinomial logistic regression failed to demonstrate predictive ability of ESS. A higher Stop-Bang score significantly increases the risk being in the “treat” group. In addition, male gender, greater age and a higher BMI each individually increase the risk of OSA requiring treatment. Stop-Bang failed to demonstrate predictive significance when age and gender were controlled for. ESS is not an appropriate screening tool for OSA. Stop-Bang, however, remains a useful screening tool, with the ability to detect patient with OSA in need of treatment. Further study may benefit the development and implementation of a concise and more specific screening tool that considers high evidence-based risk factors for OSA, including male gender, greater age and raised BMI.

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Author information

Authors and Affiliations

  1. Acute Medicine, Chelsea and Westminster Hospital, 369 Fulham Road, London, UK

    Binita Panchasara & Gary Davies

  2. Department of Medicine, Imperial College London, London, UK

    Binita Panchasara

  3. NIHR CLAHRC Northwest London, Imperial College London, London, UK

    Alan J. Poots

Authors
  1. Binita Panchasara
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  2. Alan J. Poots
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  3. Gary Davies
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Contributions

BP designed study, ran analysis, wrote first draft and contributed to ongoing writing. AJP designed analysis, ran analysis, interpreted results, and contributed to ongoing writing. GD designed study, interpreted results, and contributed to ongoing writing.

Corresponding author

Correspondence to Binita Panchasara.

Ethics declarations

This study was limited to the secondary analysis of data that were collected as part of standard clinical practice, and anonymised to all researchers.

Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

All data were collected as part of normal care and these routinely collected data were anonymous to all researchers, conforming to the Governance Arrangements for Research Ethics Committee (GAfREC) standards [36].

Informed consent

For this type of study formal consent is not required.

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Panchasara, B., Poots, A.J. & Davies, G. Are the Epworth Sleepiness Scale and Stop-Bang model effective at predicting the severity of obstructive sleep apnoea (OSA); in particular OSA requiring treatment?. Eur Arch Otorhinolaryngol 274, 4233–4239 (2017). https://doi.org/10.1007/s00405-017-4725-2

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  • DOI: https://doi.org/10.1007/s00405-017-4725-2

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