Maximilian Bailer , Maximilian I. Sprügel , Eva M. Stein , Janine Utz , Stefan Mestermann , Philipp Spitzer , Johannes Kornhuber
{"title":"精神病患者阻塞性睡眠呼吸暂停筛查问卷的诊断准确性","authors":"Maximilian Bailer , Maximilian I. Sprügel , Eva M. Stein , Janine Utz , Stefan Mestermann , Philipp Spitzer , Johannes Kornhuber","doi":"10.1016/j.jpsychires.2025.04.026","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 %).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"186 ","pages":"Pages 280-288"},"PeriodicalIF":3.7000,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diagnostic accuracy of screening questionnaires for obstructive sleep apnea in psychiatric patients\",\"authors\":\"Maximilian Bailer , Maximilian I. Sprügel , Eva M. Stein , Janine Utz , Stefan Mestermann , Philipp Spitzer , Johannes Kornhuber\",\"doi\":\"10.1016/j.jpsychires.2025.04.026\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 %).</div></div><div><h3>Conclusion</h3><div>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.</div></div>\",\"PeriodicalId\":16868,\"journal\":{\"name\":\"Journal of psychiatric research\",\"volume\":\"186 \",\"pages\":\"Pages 280-288\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-04-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of psychiatric research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0022395625002614\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of psychiatric research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022395625002614","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Diagnostic accuracy of screening questionnaires for obstructive sleep apnea in psychiatric patients
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.
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;