Diagnostic accuracy of screening questionnaires for obstructive sleep apnea in psychiatric patients

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2025-04-15 DOI:10.1016/j.jpsychires.2025.04.026

Maximilian Bailer , Maximilian I. Sprügel , Eva M. Stein , Janine Utz , Stefan Mestermann , Philipp Spitzer , Johannes Kornhuber

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引用次数: 0

Abstract

Background

Obstructive sleep apnea (OSA) is prevalent among psychiatric patients and can exacerbate psychiatric conditions. Screening for OSA in this population is challenging due to overlapping symptoms and adherence issues. This study evaluated the diagnostic accuracy of the STOP-Bang, BOAH, GOAL, NoSAS, and No-Apnea screening questionnaires in psychiatric patients.

Methods

In this observational cohort study, consecutive psychiatric patients admitted to a single tertiary care center between June 1, 2016 and December 31, 2022 were screened using the STOP-Bang questionnaire and additional data on parameters of the other questionnaires were collected. Polygraphy was performed using the Somnocheck micro CARDIO® system to record the Apnea-Hypopnea Index (AHI). Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curve, sensitivity, and specificity analysis.

Results

Among 128 patients (median age 61.5 [IQR, 52.3–73.0] years; 77 [60.2 %] men), the No-Apnea questionnaire achieved the highest sensitivity for any OSA (AHI ≤5) at 96.00 % (95 % CI, 89.35 %–98.58 %; AUC, 0.68), followed by GOAL at 92.00 % (95 % CI, 83.78 %–96.27 %; AUC, 0.59) and STOP-Bang at 90.67 % (95 % CI, 81.85 %–95.26 %; AUC, 0.66). The specificities of all questionnaires were low, ranging from 15.09 % (STOP-Bang; 95 % CI, 8.35 %–25.90 %) to 50.94 % (BOAH; 95 % CI, 38.65 %–63.13 %).

Conclusion

The STOP-Bang, GOAL, and No-Apnea questionnaires effectively identify psychiatric patients at risk for OSA, though their low specificity underscores the necessity for confirmatory diagnostics, such as polygraphy. The No-Apnea score, which relies only on objective variables, may offer particular benefits in psychiatric settings.

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精神病患者阻塞性睡眠呼吸暂停筛查问卷的诊断准确性

背景：阻塞性睡眠呼吸暂停（OSA）在精神病患者中普遍存在，并可加重精神疾病。由于症状重叠和依从性问题，在这一人群中筛查OSA具有挑战性。本研究评估STOP-Bang、BOAH、GOAL、NoSAS和No-Apnea筛查问卷对精神病患者的诊断准确性。方法在本观察性队列研究中，采用STOP-Bang问卷对2016年6月1日至2022年12月31日在单一三级医疗中心连续就诊的精神病患者进行筛选，并收集其他问卷参数的附加数据。使用Somnocheck micro CARDIO®系统进行测谎，记录呼吸暂停低通气指数（AHI）。采用受试者工作特征（ROC）曲线、敏感性和特异性分析评估诊断准确性。结果128例患者中位年龄61.5岁[IQR， 52.3-73.0]岁；77例[60.2%]男性)，无呼吸暂停问卷对任何OSA （AHI≤5）的敏感度最高，为96.00% (95% CI, 89.35% - 98.58%；AUC, 0.68)，其次是GOAL，为92.00% (95% CI, 83.78% - 96.27%；AUC, 0.59)和STOP-Bang为90.67%(95%可信区间,81.85% - -95.26%;AUC, 0.66)。所有问卷的特异性都很低，从15.09% (STOP-Bang；95% CI, 8.35% - 25.90%)至50.94% (BOAH；95% ci, 38.65% - 63.13%)。结论STOP-Bang、GOAL和No-Apnea问卷能有效识别有OSA风险的精神病患者，尽管它们的低特异性强调了确诊诊断的必要性，如测谎。无呼吸暂停评分仅依赖于客观变量，可能在精神病学设置中提供特别的益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;