Kelly Guichard1, Helena Marti-Soler2, Jean-Arthur Micoulaud-Franchi3, Pierre Philip3, Pedro Marques-Vidal4, Peter Vollenweider4, Gerard Waeber4, Martin Preisig5, José Haba-Rubio2, Raphael Heinzer6. 1. Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), Lausanne, Switzerland; CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France; Université de Bordeaux, SANPSY, USR 3413, F-33000 Bordeaux, France; Clinique du Sommeil, Bordeaux University Hospital (CHU), Bordeaux, France. 2. Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), Lausanne, Switzerland. 3. CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France; Université de Bordeaux, SANPSY, USR 3413, F-33000 Bordeaux, France; Clinique du Sommeil, Bordeaux University Hospital (CHU), Bordeaux, France. 4. Department of Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland. 5. Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland. 6. Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), Lausanne, Switzerland. Electronic address: raphael.heinzer@chuv.ch.
Abstract
BACKGROUND: Since the clinical presentation of obstructive sleep apnea syndrome (OSAS) shares common features with major depressive (MDE), the screening of OSAS is challenging in this population. The aim of this study was to assess the effectiveness of the NoSAS score in predicting the presence of OSAS among participants with current MDE and to compare it with the performance of existing screening tools. METHODS: A random sample of the population-based cohort CoLaus (Lausanne, Switzerland) underwent a psychiatric evaluation (PsyCoLaus) and a complete polysomnography at home (HypnoLaus). The effectiveness of the NoSAS score in detecting the risk of significant OSAS among current MDE participants was assessed and compared with STOP-BANG and Berlin scores. RESULTS: Among the 1761 subjects (58,75 ± 11y.o.; 47,8%men) who underwent polysomnography, significant OSAS was present in 24.0% with and 26.1% without current MDE. Using a threshold of ≥ 8 points, the NoSAS score identified OSAS in MDE participants with a sensitivity of 0.79, a specificity of 0.66, a negative predictive value of 0.91, and a positive predictive value of 0.41. The area under the ROC curve was 0.72 for NoSAS, 0.66 for STOP-BANG and 0.69 for the Berlin score (NS). LIMITATIONS: Only 44% of the PsyCoLaus participants had a polysomnography. The studied population was mainly of Caucasian ancestry and above 40 years of age. CONCLUSIONS: This is the first study assessing the performance of screening tools for OSAS in MDE. The NoSAS score is a simple and efficient screening tool for OSAS in this population, and may be a helpful instrument for clinicians.
BACKGROUND: Since the clinical presentation of obstructive sleep apnea syndrome (OSAS) shares common features with major depressive (MDE), the screening of OSAS is challenging in this population. The aim of this study was to assess the effectiveness of the NoSAS score in predicting the presence of OSAS among participants with current MDE and to compare it with the performance of existing screening tools. METHODS: A random sample of the population-based cohort CoLaus (Lausanne, Switzerland) underwent a psychiatric evaluation (PsyCoLaus) and a complete polysomnography at home (HypnoLaus). The effectiveness of the NoSAS score in detecting the risk of significant OSAS among current MDEparticipants was assessed and compared with STOP-BANG and Berlin scores. RESULTS: Among the 1761 subjects (58,75 ± 11y.o.; 47,8%men) who underwent polysomnography, significant OSAS was present in 24.0% with and 26.1% without current MDE. Using a threshold of ≥ 8 points, the NoSAS score identified OSAS in MDEparticipants with a sensitivity of 0.79, a specificity of 0.66, a negative predictive value of 0.91, and a positive predictive value of 0.41. The area under the ROC curve was 0.72 for NoSAS, 0.66 for STOP-BANG and 0.69 for the Berlin score (NS). LIMITATIONS: Only 44% of the PsyCoLaus participants had a polysomnography. The studied population was mainly of Caucasian ancestry and above 40 years of age. CONCLUSIONS: This is the first study assessing the performance of screening tools for OSAS in MDE. The NoSAS score is a simple and efficient screening tool for OSAS in this population, and may be a helpful instrument for clinicians.
Authors: Jan Rémi; Thomas Pollmächer; Kai Spiegelhalder; Claudia Trenkwalder; Peter Young Journal: Dtsch Arztebl Int Date: 2019-10-11 Impact factor: 5.594
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