Predictive ability of the International Classification of Sleep Disorders-3 in identifying risk of obstructive sleep apn
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SLEEP BREATHING PHYSIOLOGY AND DISORDERS • ORIGINAL ARTICLE
Predictive ability of the International Classification of Sleep Disorders-3 in identifying risk of obstructive sleep apnea among recently unemployed adults Graciela E. Silva 1
&
Darlynn M. Rojo-Wissar 2,3 & Stuart F. Quan 4 & Patricia L. Haynes 2
Received: 30 April 2020 / Revised: 21 September 2020 / Accepted: 2 October 2020 # Springer Nature Switzerland AG 2020
Abstract Background The International Classification of Sleep Disorders (ICSD)-3 was developed to aid in the identification of these disorders. The core criterion A (ICSD-3A) to identify obstructive sleep apnea (OSA) requires the presentence of specific signs and symptoms. This study explores the predictive ability of the ICSD-3A for OSA as compared with objective measures of respiratory event index (REI). Participants A total of 291 participants who completed a home sleep apnea test (HSAT) during the screening evaluation of the Assessing Daily Activity Patterns through occupational Transitions (ADAPT) study were included. Methods Participants were classified as having mild OSA (REI ≥ 5 and < 15), moderate (≥ 15 to < 30), or severe OSA (> 30). Predictive parameters identifying participants as having OSA by the ICSD-3A criteria were assessed using REI classifications as the reference standard and further compared with a subsample using the STOP-Bang questionnaire. Results The ICSD-3A had a sensitivity of 19.2% for identifying participants as having moderate to severe OSA and specificity of 84.4%. The ICSD-3A had a receiver operating characteristics (ROC) = 0.53. On the subsample of participants, the STOP-Bang questionnaire’s ROC is 0.61. Results were similar when examining the classification of participants with mild compared with no OSA. Conclusion In this population, the ability of the ICSD-3A in detecting moderate to severe OSA as well as mild OSA was low. The ROC for the ICSD-3 did not differ significantly from the STOP-Bang questionnaire’s ROC in this research population. Keywords Obstructive sleep apnea . Sleep . Job loss . International Classification of Sleep Disorders
Introduction The International Classification of Sleep Disorders (ICSD)-3 diagnostic standards criterion include a section A (ICSD-A) for obstructive sleep apnea (OSA) and requires signs and symptoms
* Graciela E. Silva [email protected] 1
College of Nursing, University of Arizona, Tucson, AZ, USA
2
Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
3
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
4
Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
related to associated sleepiness, fatigue, insomnia, snoring, subjective nocturnal respiratory disturbance, and observed apnea, or associated medical or psychiatric disorders [1]. Previous research, however, suggests that these scoring criteria can affect the prevalence of OS
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