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Poor performance of screening questionnaires for obstructive sleep apnea in male commercial drivers

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Screening commercial drivers (CDs) for obstructive sleep apnea (OSA) reduces the risk of motor vehicle accidents. We evaluated the accuracy of standard OSA questionnaires in a cohort of CDs.

Study design and methods

We enrolled consecutive male CDs at 10 discrete transportation companies during their yearly scheduled occupational health visit. The CDs had their anthropometric measures taken; completed the Berlin, STOP, STOP-BANG, OSAS-TTI, SACS, EUROSAS, and ARES questionnaires; and underwent a home sleep apnea test (HSAT) for the determination of their respiratory events index (REI). We assessed the questionnaires’ ability to predict OSA (REI ≥ 5 events/h) and moderate-to-severe OSA (REI ≥ 15 events/h).

Results

Among 315 CDs recruited, 243 (77%) completed the study protocol, while 72 subjects were excluded for inadequate HSAT quality. The demographics and clinical data were comparable in both the included and excluded subjects. The included CDs had a median age of 50 years (interquartile range (IQR) 25–70) and a mean body mass index of 27 ± 4 kg/m2. One hundred and seventy-one subjects (71%) had OSA, and 68 (28%) had moderate-to-severe OSA. A receiver operating characteristic curve of the questionnaires were 0.51–0.71 for predicting OSA and 0.51–0.66 for moderate-to-severe OSA. The STOP-BANG questionnaire had an unsatisfactory positive predictive value, while all of the other questionnaires had an inadequate negative predictive value.

Conclusions

Standard OSA questionnaires are not suited for screening among CDs. The use of the HSAT could provide an objective evaluation of for OSA in this special population.

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Data availability

The original data are available upon reasonable request.

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Acknowledgements

The authors are grateful to Professor Maria Rosaria Bonsignore for her valuable suggestions and comments that contributed to improving the quality of this manuscript.

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Authors and Affiliations

  1. Department of Neurology, Sleep Center, IRCCS Sacro Cuore Don Calabria, via Sempreboni 6, 37024, Negrar, Verona, Italy

    Alessandro Adami, Davide Tonon, Antonio Corica, Deborah Trevisan & Gianluca Rossato

  2. Clinical Research Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy

    Giovanni Cipriano

  3. Clinical Research Unit, IRCCS Sacro Cuore Don Calabria, Negrar, Verona, Italy

    Nicoletta De Santis & Massimo Guerriero

  4. Department of Cultures and Civilizations, University of Verona, Verona, Italy

    Massimo Guerriero

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  1. Alessandro Adami
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Contributions

AA, DT, AC, DT, and GR were involved in the design of the study, data collection, and interpretation and provided critical revision of the manuscript and intellectual discussion.

GC, MG, and NDS were involved in the data analysis and interpretation.

All authors were substantially involved in drafting the article and approved this final version of the manuscript.

Corresponding author

Correspondence to Alessandro Adami.

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Ethics approval and consent to participate

All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Ethical Committee of Verona and Rovigo Provinces (842CESC), and informed consent was obtained from all participants. All included subjects gave informed consent to participate in the study. Anonymity of personal data and reports was guaranteed by the study protocol.

Conflict of interest

The authors declare no competing interests.

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Adami, A., Tonon, D., Corica, A. et al. Poor performance of screening questionnaires for obstructive sleep apnea in male commercial drivers. Sleep Breath 26, 541–547 (2022). https://doi.org/10.1007/s11325-021-02414-z

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  • DOI: https://doi.org/10.1007/s11325-021-02414-z

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