Screening efficiencies of obstructive sleep apnea screening scales in patients with acute ischemic stroke

OBJECTIVE: To evaluate the application of various obstructive sleep apnea (OSA) screening scales in patients with acute ischemic stroke. METHODS: One hundred and two patients with acute ischemic stroke were enrolled continuously during July 2016 and March 2017 from Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. All patients were assessed by the same physician with various OSA screening scales, including Epworth scale, Berlin questionnaire, STOP-Bang questionnaire, SOS scale, four-variable scale and its modified version. Polysomnography was performed in Sleeping Disorder Center on each patient. According to the apnea-hypopnea index (AHI) acquired from polysomnography, patients were divided into moderate-severe OSA group (AHI ≥ 15, n=58) and normal-mild OSA group (AHI<15, n=44). The efficiencies of the scales in identification of patients with moderate or severe OSA were analyzed and compared. RESULTS: The ROC curves showed that the four-variable scale and its modified version had higher area under curve (0.806 and 0.807, both P<0.01) for diagnosis of moderate-severe OSA, and the cut-off values for Epworth scale, Berlin questionnaire, STOP-Bang questionnaire, SOS scale, four-variable scale and its modified version were 9, 2, 4, 15, 11, 10, respectively. The sensitivities, specificities, positive and negative predictive values of four-variable scale and its modified version in diagnosis of moderate-severe OSA were higher than those of other scales. CONCLUSIONS: Compared with Epworth scale, Berlin questionnaire, STOP-Bang questionnaire and SOS scale, the four-variable scale and its modified version are more effective in screening of OSA for patients with acute ischemic stroke.