Work

Performance of Four Screening Tools for Identifying Obstructive Sleep Apnea Among Patients with Insomnia

Year: 2025

Type: article

Abstract: Purpose: Co-morbid insomnia and sleep apnea are common in clinical practice. The existing OSA screening tools have not been fully validated in insomnia populations, and items measuring daytime function may be interfered with the presence of insomnia. This study aims to validate the performance of four commonly used OSA screening tools among individuals with and without insomnia. Participants and Methods: A cross-sectional survey was conducted in individuals with suspected OSA referred for sleep studies from December 2021 to December 2023. All participants completed the Insomnia Severity Index (ISI) scale, STOP-Bang, Epworth Sleepiness Scale (ESS), Berlin questionnaire, and NoSAS score. Clinical insomnia was defined as an ISI of 15 or more. Performance of screening tools was primarily assessed by sensitivity, specificity, and the receiver operating characteristic (ROC) curve. Results: >0.05). In presence of insomnia, the STOP-Bang, ESS, and Berlin questionnaire demonstrated higher sensitivity but lower specificity. Using conventional cutoffs, the STOP-Bang had the highest level of sensitivity (93.2%, 95% CI 87.6-96.5%), while NoSAS had the highest level of specificity (67.7%, 95% CI 59.9-74.6%) for identifying AHI ≥15/h. The STOP-Bang and NoSAS outperformed ESS and Berlin with areas under the ROC curve >0.7 at all levels of OSA severity. The Youden's index was maximized at score 4 for STOP-Bang and score 7 for NoSAS. Conclusion: The performance of OSA screening tools incorporating evaluation of daytime function is altered in the presence of insomnia. Under conventional cutoffs, STOP-Bang is the preferred screening tool due to its high sensitivity.

Source: Nature and Science of Sleep

DOI: 10.2147/nss.s494804

Authors: Chuan Shi, Yuxin Wang, Jinmei Luo, Rong Huang, Yi Xiao

Institutions: Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital

Language: English

Topic: Obstructive Sleep Apnea Research

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836