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Prediction of obstructive sleep apnea syndrome in a large Greek population

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Abstract

Purpose

We aimed to evaluate the predictive value of anthropometric measurements and self-reported symptoms of obstructive sleep apnea syndrome (OSAS) in a large number of not yet diagnosed or treated patients. Commonly used clinical indices were used to derive a prediction formula that could identify patients at low and high risk for OSAS.

Methods

Two thousand six hundred ninety patients with suspected OSAS were enrolled. We obtained weight; height; neck, waist, and hip circumference; and a measure of subjective sleepiness (Epworth sleepiness scale—ESS) prior to diagnostic polysomnography. Excessive daytime sleepiness severity (EDS) was coded as follows: 0 for ESS ≤ 3 (normal), 1 for ESS score 4–9 (normal to mild sleepiness), 2 for score 10–16 (moderate to severe sleepiness), and 3 for score >16 (severe sleepiness). Multivariate linear and logistic regression analysis was used to identify independent predictors of apnea–hypopnea index (AHI) and derive a prediction formula.

Results

Neck circumference (NC) in centimeters, body mass index (BMI) in kilograms per square meter, sleepiness as a code indicating EDS severity, and gender as a constant were significant predictors for AHI. The derived formula was: \( {\hbox{AHIpred}} = {\hbox{NC}} \times 0.{84} + {\hbox{EDS}} \times {7}.{78} + {\hbox{BMI}} \times 0.{91} - [{8}.{2} \times {\hbox{gender constant }}\left( {\hbox{1 or 2}} \right) + {37}] \). The probability that this equation predicts AHI greater than 15 correctly was 78%.

Conclusions

Gender, BMI, NC, and sleepiness were significant clinical predictors of OSAS in Greek subjects. Such a prediction formula can play a role in prioritizing patients for PSG evaluation, diagnosis, and initiation of treatment.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Sleep Disorders Unit, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, P.O. BOX: 1352, Voutes, 71110, Heraklion, Crete, Greece

    Izolde Bouloukaki, Nikos Tzanakis, Violeta Moniaki, Eleni M. Vlachaki, Nikolaos M. Siafakas & Sophia E. Schiza

  2. Department of Epidemiology, Social Medicine, Medical School of the University of Crete, Heraklion, Greece

    Nikos Tzanakis

  3. Sleep Disorders Center, 401 General Army Hospital, Athens, Greece

    Charalampos Mermigkis

  4. Sleep Disorders Center, Henry Dunant Hospital, Athens, Greece

    Fotis Kapsimalis, Charalampos Mermigkis, Panagiotis Panagou & Georgios Varouchakis

  5. Sleep Medicine, Research and Education, Gaylord Hospital, Wallingford, CT, USA

    Meir Kryger

Authors
  1. Izolde Bouloukaki
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  2. Fotis Kapsimalis
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  7. Violeta Moniaki
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  8. Eleni M. Vlachaki
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  9. Georgios Varouchakis
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  10. Nikolaos M. Siafakas
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Correspondence to Izolde Bouloukaki.

Additional information

Izolde Bouloukaki and Fotis Kapsimalis had the same contribution in this work

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Bouloukaki, I., Kapsimalis, F., Mermigkis, C. et al. Prediction of obstructive sleep apnea syndrome in a large Greek population. Sleep Breath 15, 657–664 (2011). https://doi.org/10.1007/s11325-010-0416-6

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  • DOI: https://doi.org/10.1007/s11325-010-0416-6

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