Nature and Science of Sleep (Mar 2023)

Establishment and Application Evaluation of an Improved Obstructive Sleep Apnea Screening Questionnaire for Chinese Community: The CNCQ-OSA

  • Wang D,
  • Ren Y,
  • Chen R,
  • Zeng X,
  • Gan Q,
  • Zhuang Z,
  • Su X,
  • Wu K,
  • Zhang S,
  • Tang Y,
  • Li S,
  • Zhang H,
  • Zhou Y,
  • Zhang N,
  • Zhao D

Journal volume & issue
Vol. Volume 15
pp. 103 – 114

Abstract

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Donghao Wang,1,* Yingying Ren,2,* Riken Chen,1,* Xiangxia Zeng,1,* Qiming Gan,1,* Zhiyang Zhuang,1 Xiaofen Su,1 Kang Wu,1 Sun Zhang,1 Yongkang Tang,1 Shiwei Li,1 Haojie Zhang,1,3 Yanyan Zhou,1 Nuofu Zhang,1 Dongxing Zhao1 1State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China; 2Medical Records and Statistics Room, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China; 3The Clinical Medicine Department, Henan University, Zhengzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Dongxing Zhao; Nuofu Zhang, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China, Tel +86-13650901411 ; +86-13600460056, Email [email protected]; [email protected]: Obstructive sleep apnea (OSA) is a common sleep-disordered breathing disease. We aimed to establish an improved screening questionnaire without physical examinations for OSA named the CNCQ-OSA (Chinese community questionnaire for OSA).Methods: A total of 2585 participants who visited sleep medicine center and underwent overnight polysomnography were grouped into two independent cohorts: derivation (n = 2180) and validation (n = 405). The CNCQ-OSA was designed according to the baseline of patients in derivation cohort. We comprehensively analyzed the data to evaluate the predictive value of the CNCQ-OSA, compared to the GOAL questionnaire, STOP-Bang questionnaire (SBQ) and NoSAS questionnaire.Results: The CNCQ-OSA included seven variables: loud snoring, BMI ≥ 25 kg/m2, male gender, apnea, sleepiness, hypertension and age ≥ 30, with a total score ranging from 7 to 16.7 points (≥ 13.5 points indicating high risk of OSA, ≥ 14.5 points indicating extremely high risk). In the derivation and validation cohorts, the areas under the curve of the CNCQ-OSA were 0.761 and 0.767, respectively. In the validation cohort, the sensitivity and specificity of a CNCQ-OSA score ≥ 13.5 points for the apnea–hypopnea index (AHI) ≥ 5/h were 0.821 and 0.559, respectively (Youden index, 0.380), and the score ≥ 14.5 points were 0.494 and 0.887, respectively (Youden index, 0.375). The CNCQ-OSA had a better predictive value for AHI ≥ 5/h, AHI > 15/h and AHI > 30/h, with the highest Youden index, compared to the other questionnaires.Conclusion: The CNCQ-OSA can effectively identify the risk of OSA, which is appropriate for self-screening at home without physical examinations.Keywords: obstructive sleep apnea, screening, GOAL, STOP-Bang, NoSAS

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