[Clinical application of the Epworth sleepiness score in pregnant women with obstructive sleep apnea-hypopnea syndrome].
Zhong Xu, Hong Ye, Taoping Li, Dunjin Chen, Huishu Liu, Chun-huan Gao
Abstract
Zhong Xu, Hong Ye, Taoping Li, Dunjin Chen, Huishu Liu, Chun-huan Gao
Abstract
OBJECTIVE: To provide a convenient method for screening obstructive sleep apnea-hypopnea syndrome (OSAHS) in pregnant women. METHODS: Seventy-eight pregnant women with suspected OSAHS were calculated for the EP index using Epworth sleepiness score (ESS) with also measurement of the neck circumference (NC) and body mass index (BMI). The apnea/hypopnea index (AHI) was calculated and the lowest SaO(2) (LSaO(2)) measured through a 7-h polysomnography (PSG). The women were then divided into 4 groups according to the AHI and LSaO(2). The ESS was compared with the PSG-AHI and the receiver operating characteristic curve (ROC) was generated. RESULTS: All the clinical indexes (NC, BMI, EP, AHI, and LSaO(2)) showed significant differences between the 4 groups (P<0.05). EP and PSG were found to have greater correlations to AHI (r=0.759, P=0.000) than NC (r=0.668) and BMI (r=0.663). The area under the ROC of the EP (0.825) was greater than that of NC (0.772) and BMI (0.784). The index of EP showed greater clinical diagnostic value of OSAHS in pregnancy. Base on the ROC, EP at the optimal operating point of 7.5 had a sensitivity of 76.8% and specificity of 68.2% for diagnosis of OSAHS in pregnant women. CONCLUSION: The ESS is an economic and convenient method for screening OSAHS in pregnant women with high diagnostic sensitivity and specificity.
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OBJECTIVE: To provide a convenient method for screening obstructive sleep apnea-hypopnea syndrome (OSAHS) in pregnant women. METHODS: Seventy-eight pregnant women with suspected OSAHS were calculated for the EP index using Epworth sleepiness score (ESS) with also measurement of the neck circumference (NC) and body mass index (BMI). The apnea/hypopnea index (AHI) was calculated and the lowest SaO(2) (LSaO(2)) measured through a 7-h polysomnography (PSG). The women were then divided into 4 groups according to the AHI and LSaO(2). The ESS was compared with the PSG-AHI and the receiver operating characteristic curve (ROC) was generated. RESULTS: All the clinical indexes (NC, BMI, EP, AHI, and LSaO(2)) showed significant differences between the 4 groups (P<0.05). EP and PSG were found to have greater correlations to AHI (r=0.759, P=0.000) than NC (r=0.668) and BMI (r=0.663). The area under the ROC of the EP (0.825) was greater than that of NC (0.772) and BMI (0.784). The index of EP showed greater clinical diagnostic value of OSAHS in pregnancy. Base on the ROC, EP at the optimal operating point of 7.5 had a sensitivity of 76.8% and specificity of 68.2% for diagnosis of OSAHS in pregnant women. CONCLUSION: The ESS is an economic and convenient method for screening OSAHS in pregnant women with high diagnostic sensitivity and specificity.
Key concepts: Medicine, Hypopnea, Polysomnography, Receiver operating characteristic, Body mass index, Obstructive sleep apnea, Epworth Sleepiness Scale, Internal medicine