Open AccessSTOP-Bang questionnaire should be used in all adults with Down Syndrome to screen for moderate to severe obstructive sleep apnea
Author(s) -
Anderson Albuquerque de Carvalho,
Fábio Ferreira Amorim,
Levy Aniceto Santana,
Karlo Jozefo Quadros de Almeida,
Alfredo Nicodemos Cruz Santana,
Francisco A. R. Neves
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0232596
Subject(s) - medicine , obstructive sleep apnea , epworth sleepiness scale , polysomnography , population , sleep apnea , hematocrit , physical therapy , bayesian multivariate linear regression , cross sectional study , sleep study , pediatrics , apnea , linear regression , pathology , environmental health , machine learning , computer science
Study objectives To determine the prevalence of obstructive sleep apnea (OSA) in adults with Down syndrome (DS), to investigate factors related to OSA severity and to identify which sleep questionnaire is the most appropriate for the screening of OSA in this population. Methods Cross-sectional study that consecutively included 60 adults with DS. All patients underwent type III polysomnography and clinical and laboratory data were collected; sleep assessment questionnaires were applied. Multiple linear regression models evaluated the associations between OSA severity (measured by the respiratory event index—REI) and clinical and laboratory data and sleep questionnaires (Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, BERLIN and STOP-Bang questionnaires). Results Results show that 60 (100%) adults with DS had OSA, with moderate-severe OSA identified in 49 (81.6%). At the multivariate linear regression, REI significantly correlated with hematocrit levels, BMI and STOP-Bang questionnaire (SBQ) results (P <0.001). The positive STOP-Bang ≥3 points) showed 100% of sensitivity (95%CI: 92.75–100%), 45.45% of specificity (95%CI: 16.75–76.62), positive predictive value of 89.09% (95%CI: 82.64–93.34%), negative predictive value of 100%, accuracy of 90% (95%CI: 79.49–96.24%) and OR of 24.29. Conclusions Adults with DS have a very high prevalence of OSA. Hematocrit levels, BMI and SBQ showed a strong correlation with OSA severity. The SBQ performed well in identifying moderate to severe OSA in this population. Considered together, these results point to the need to perform OSA screening in all adults with DS, and STOP-Bang may play a role in this screening.