Screening for Obstructive Sleep Apnea by Standard Recommended Tools and Its Associated Comorbidities in a Subset of Eastern Indian Surgical Population: An Observational Study.

Background and aims: Obstructive sleep apnea/hypopnea syndrome (OSAHS) is underdiagnosed, and patients commonly have a lengthened and difficult hospital stay associated with cardiovascular, respiratory, and neurological complications. Therefore, timely diagnosis using screening tools, especially in resource-poor setups, is essential in preventing an adverse surgical course and delivering optimum patient care. Thus, we intended to highlight the proportion of patients with OSAHS presenting for various surgical procedures and compare the sensitivity of the screening tools when used individually and in various combinations.

Methods: We conducted this prospective observational study with 527 subjects from January 2018 to January 2020. The prevalence of OSAHS was calculated by the simultaneous administration of the Berlin questionnaire, STOP-Bang score, American Society of Anesthesiologists (ASA) checklist, and Preoperative Sleep Apnea Prediction (PSAP) score. These screening tools were also used individually and in combinations of two and three to ascertain the most sensitive combination. Using bivariate logistic regression followed by multivariate logistic regression, associations between OSAHS and various anthropometric measurements were also established.

Results: Four screening tools simultaneously detected the presence of OSAHS in the maximum number of subjects (74.95%), matched by the administration of STOP-Bang, Berlin, and PSAP screening tools in conjunction. Among combinations of any two tools, STOP-Bang and PSAP established OSAHS in 74.38% of respondents, whereas individually, the highest number of cases was observed using the PSAP score (67.17%).

Conclusion: OSAHS is frequently encountered in surgical patients. The STOP-Bang and PSAP screening tools, in combination, are the most sensitive and convenient choice for detecting OSAHS.