Prospective study on the diagnostic model of obstructive sleep apnea_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 SUN Kai ¹ , LEI Fei ² , ZHENG Aibo ¹ , ZHOU Liping ¹ , MA Shengjun ¹ , LIU Yong ¹ , PENG Juan ¹

1. Department of Pulmonary and Critical Care Medicine, Zigong Fourth People’s Hospital, Zigong, Sichuan 643000, P.R.China;
2. Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China;

Corresponding author：

SUN Kai, Email: 26576628@qq.com

Keywords：

Sleep apnea obstructive; diagnostic model; prospective studies; polysomnography

DOI：

10.7507/1671-6205.202412073

Video：

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Objective To prospectively verify the accuracy and reliability of the diagnostic model of obstructive sleep apnea (OSA), including the probability model and disease severity model, and to explore a simple and cost-effective method for screening of OSA. Methods A total of 996 patients who underwent polysomnography in Zigong Fourth People’s Hospital(590 cases) and West China Hospital of Sichuan University(406 cases) were consecutively and prospectively included as the research subjects. Firstly, the OSA diagnostic model was used for the diagnostic test; then polysomnography was performed; Finally, taking polysomnography as the gold standard, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and area under the ROC curve of OSA diagnostic model were calculated, and the reliability analysis of the model’s results was carried out. Results The sensitivity, specificity and accuracy of the OSA diagnostic model were 76.38%(595/779), 83.41%(181/217) and 77.91%(776/996) respectively, the positive predictive value is 94.29%, negative predictive value is 45.49%, positive likelihood ratio is 4.604, negative likelihood ratio is 0.283; and the area under the ROC curve was 0.866. The reliability analysis of OSA diagnostic model showed that there was no significant difference in the bias comparison of AHI; the intra-class correlation coefficient(ICC) between AHI in the OSA diagnostic model and AHI in polysomnography was 0.659, with a relatively strong consistency degree; the intra-class correlation coefficient between the lowest SpO₂ in the OSA diagnostic model and the lowest SpO₂ in polysomnography was 0.563, with a moderate consistency degree. Conclusions The OSA diagnostic model can better predict the probability of illness and assess the severity of the disease, which is helpful for the early detection, diagnosis and treatment of OSA. The OSA diagnostic model is suitable for popularization and application in primary hospitals and when polysomnography is not available in time.

Citation： SUN Kai, LEI Fei, ZHENG Aibo, ZHOU Liping, MA Shengjun, LIU Yong, PENG Juan. Prospective study on the diagnostic model of obstructive sleep apnea. Chinese Journal of Respiratory and Critical Care Medicine, 2025, 24(2): 92-96. doi: 10.7507/1671-6205.202412073 Copy

1.	阻塞性睡眠呼吸暂停低通气综合征诊治指南(基层版)写作组. 阻塞性睡眠呼吸暂停低通气综合征诊治指南(基层版). 中国呼吸与危重监护杂志, 2015, 14(4): 398-405.
2.	Akashiba T, Inoue Y, Uchimura N, et al. Sleep Apnea Syndrome (SAS) Clinical Practice Guidelines 2020. Respir Investig, 2022, 60(1): 3-32.
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4.	Zasadzińska-Stempniak K, Zajączkiewicz H, Kukwa A. Prevalence of Obstructive Sleep Apnea in the Young Adult Population: A Systematic Review. J Clin Med, 2024, 13(5): 1386.
5.	Godoy PH, Nucera APCDS, Colcher AP, et al. Screening for obstructive sleep apnea in elderly: performance of the Berlin and STOP-Bang questionnaires and the Epworth sleepiness scale using polysomnography as gold standard. Sleep Sci, 2022, 15(2): 136-142.
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9.	孙楷, 聂洪玉, 徐东兰, 等. 鼾症中OSAHS的预测模型及危险因素分析. 国际呼吸杂志, 2019, 39(14): 1067-1072.
10.	Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep, 1991, 14(6): 540-545.
11.	American Academy of Sleep Medicine. The AASM Manual for the Scoring of Sleep and Associated Events Summary of Updates in Version 2.6. https://aasm.org/clinical-resources/scoring-manual/.
12.	中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 成人阻塞性睡眠呼吸暂停基层诊疗指南(2018年). 中华全科医师杂志, 2019, 18(1): 21-29.
13.	Iannella G, Maniaci A, Magliulo G, et al. Current challenges in the diagnosis and treatment of obstructive sleep apnea syndrome in the elderly. Pol Arch Intern Med, 2020, 130(7-8): 649-654.
14.	陆林. 中国睡眠医学中心标准化建设指南[M]. 北京: 人民卫生出版社, 2021, 5-8.
15.	de Araujo Dantas AB, Gonçalves FM, Martins AA, et al. Worldwide prevalence and associated risk factors of obstructive sleep apnea: a meta-analysis and meta-regression. Sleep Breath, 2023, 27(6): 2083-2109.
16.	Gottlieb DJ, Punjabi NM. Diagnosis and Management of Obstructive Sleep Apnea: A Review. JAMA, 2020, 323(14): 1389-1400.

1. 阻塞性睡眠呼吸暂停低通气综合征诊治指南(基层版)写作组. 阻塞性睡眠呼吸暂停低通气综合征诊治指南(基层版). 中国呼吸与危重监护杂志, 2015, 14(4): 398-405.
2. Akashiba T, Inoue Y, Uchimura N, et al. Sleep Apnea Syndrome (SAS) Clinical Practice Guidelines 2020. Respir Investig, 2022, 60(1): 3-32.
3. Benjafield AV, Ayas NT, Eastwood PR, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med, 2019, 7(8): 687-698.
4. Zasadzińska-Stempniak K, Zajączkiewicz H, Kukwa A. Prevalence of Obstructive Sleep Apnea in the Young Adult Population: A Systematic Review. J Clin Med, 2024, 13(5): 1386.
5. Godoy PH, Nucera APCDS, Colcher AP, et al. Screening for obstructive sleep apnea in elderly: performance of the Berlin and STOP-Bang questionnaires and the Epworth sleepiness scale using polysomnography as gold standard. Sleep Sci, 2022, 15(2): 136-142.
6. Behar JA, Palmius N, Li Q, et al. Feasibility of Single Channel Oximetry for Mass Screening of Obstructive Sleep Apnea. EClinicalMedicine, 2019, 11: 81-88.
7. 张静, 何珊, 陈洁, 等. 建立基于临床数据的儿童阻塞性睡眠呼吸暂停综合征预测模型. 医学综述, 2020, 26(11): 2223-2227+2234.
8. 孙楷, 聂洪玉, 徐东兰, 等. 鼾症患者中阻塞性睡眠呼吸暂停低通气综合征的筛查及危险因素分析. 中国呼吸与危重监护杂志, 2019, 18(1): 26-30.
9. 孙楷, 聂洪玉, 徐东兰, 等. 鼾症中OSAHS的预测模型及危险因素分析. 国际呼吸杂志, 2019, 39(14): 1067-1072.
10. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep, 1991, 14(6): 540-545.
11. American Academy of Sleep Medicine. The AASM Manual for the Scoring of Sleep and Associated Events Summary of Updates in Version 2.6. https://aasm.org/clinical-resources/scoring-manual/.
12. 中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 成人阻塞性睡眠呼吸暂停基层诊疗指南(2018年). 中华全科医师杂志, 2019, 18(1): 21-29.
13. Iannella G, Maniaci A, Magliulo G, et al. Current challenges in the diagnosis and treatment of obstructive sleep apnea syndrome in the elderly. Pol Arch Intern Med, 2020, 130(7-8): 649-654.
14. 陆林. 中国睡眠医学中心标准化建设指南[M]. 北京: 人民卫生出版社, 2021, 5-8.
15. de Araujo Dantas AB, Gonçalves FM, Martins AA, et al. Worldwide prevalence and associated risk factors of obstructive sleep apnea: a meta-analysis and meta-regression. Sleep Breath, 2023, 27(6): 2083-2109.
16. Gottlieb DJ, Punjabi NM. Diagnosis and Management of Obstructive Sleep Apnea: A Review. JAMA, 2020, 323(14): 1389-1400.

Chinese Journal of Respiratory and Critical Care Medicine

Prospective study on the diagnostic model of obstructive sleep apnea

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