Clinical application of a previously validated pregnancy-specific screening tool for sleep apnea in a cohort with a high prevalence of obesity

Sakshi Bajaj; A. Lauren Rice; Payden White; Abigail M. Wiedmer; Natalie M. Jacobson; Nathan R. Jones; Mihaela H. Bazalakova; Kathleen M. Antony

Sleep Medicine: X (Dec 2023)

Clinical application of a previously validated pregnancy-specific screening tool for sleep apnea in a cohort with a high prevalence of obesity

Sakshi Bajaj,
A. Lauren Rice,
Payden White,
Abigail M. Wiedmer,
Natalie M. Jacobson,
Nathan R. Jones,
Mihaela H. Bazalakova,
Kathleen M. Antony

Affiliations

Sakshi Bajaj: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Wisconsin-Madison, School of Medicine and Public Health, 1010 Mound Street, Madison, WI, USA
A. Lauren Rice: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Wisconsin-Madison, School of Medicine and Public Health, 1010 Mound Street, Madison, WI, USA; Department of Biology, University of Wisconsin-Madison, Madison, WI, USA; Department of Neurology, Wisconsin Sleep, Wisconsin Institute for Sleep and Consciousness, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
Payden White: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Wisconsin-Madison, School of Medicine and Public Health, 1010 Mound Street, Madison, WI, USA; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
Abigail M. Wiedmer: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Wisconsin-Madison, School of Medicine and Public Health, 1010 Mound Street, Madison, WI, USA; Department of Biology, University of Wisconsin-Madison, Madison, WI, USA; Department of Neurology, Wisconsin Sleep, Wisconsin Institute for Sleep and Consciousness, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
Natalie M. Jacobson: Department of Biology, University of Wisconsin-Madison, Madison, WI, USA; Department of Neurology, Wisconsin Sleep, Wisconsin Institute for Sleep and Consciousness, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
Nathan R. Jones: University of Wisconsin Survey Center, University of Wisconsin-Madison, Madison, WI, USA
Mihaela H. Bazalakova: Department of Neurology, Wisconsin Sleep, Wisconsin Institute for Sleep and Consciousness, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
Kathleen M. Antony: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Wisconsin-Madison, School of Medicine and Public Health, 1010 Mound Street, Madison, WI, USA; Corresponding author. 1010 Mound Street, Madison, WI, 53715, USA.

Journal volume & issue: Vol. 5
p. 100061

Abstract

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Objective: The purpose of this project was to determine the positive predictive value of existing obstructive sleep apnea (OSA) screening tools in clinical use, in a real-world clinical population of gravidae, and to explore the development of a new questionnaire for screening for OSA during pregnancy. Methods: Pregnant people were administered sleep screening questionnaires as part of routine clinical care. These included Facco's four variable OSA screening tool, the STOP-BANG, and the Epworth Sleepiness Scale. Those who screened positive were referred for diagnostic sleep testing, typically with a type III home monitoring device. Here we analyzed the screening responses used by those who completed diagnostic testing to determine the positive predictive value of the existing tools. Results: 159 pregnant people completed diagnostic OSA testing and were included in this analysis. The positive predictive value of Facco's four variable sleep screening tool was 74.3%, STOP-BANG was 75.3%, and the Epworth Sleepiness Scale was 69.8%. Our sample size was insufficient to create a new screening tool. Conclusions: Here we calculated the positive predictive value of Facco's 4 variable screening tool for screening for OSA in pregnancy in a real-world pregnant population. While we were not able to generate a new screening tool for screening for OSA during pregnancy, both STOP-BANG and Facco's four variable tool had positive predictive values over 70% in our population which was characterized by high BMI and advanced maternal age. Increased clinical use of the pregnancy-specific tool may be warranted.

Published in Sleep Medicine: X

ISSN: 2590-1427 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine
Website: https://www.journals.elsevier.com/sleep-medicine-x

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