Pre-test Probability Scores in Patients with Obstructive Sleep Apnea

Introduction: Obstructive sleep apnea (OSA) is a prevalent sleep disorder that significantly impacts both quality of life and cardiovascular health. Various pretest probability scores are employed to identify high-risk patients before formal diagnostic testing like polysomnography (PSG). These scores, including sleep apnea clinical score (SACS), STOP-Bang, and the Epworth Sleepiness Scale (ESS), can help in estimating the likelihood and severity of OSA. This study aims to evaluate the association between these pretest probability scores and the severity of OSA in patients. Methodology: A total of 100 patients were included in the study. The participants were assessed using several pretest probability scores, including SACS, STOP-Bang, and ESS. Demographic data, such as age and gender, were collected, and the prevalence of symptoms such as snoring, daytime sleepiness, and apneas was recorded. The severity of OSA was then determined through PSG. The relationship between pretest scores and PSG findings was analyzed statistically. Results: Our study had a total of 100 participants. Mean age of the population was 53.46 years. Fifty-six patients were men (56%) and 44 patients were women (44%). Snoring was the most prevalent symptom (80%), followed by daytime sleepiness (58%) and apnea (56%). SACS score of the participants was <43: In 38 cases, 43–48: In 32 cases, >48 in 30 cases. The “STOP-Bang Questionnaire” were 0–2 (low risk) in 5 cases, 3–4 (moderate risk) in 54 cases, and ≥5 (high risk) in 41 cases. 57% of cases had ESS of more than 10. On PSG, 46 patients had mild OSA, 22 patients had moderate OSA, and 32 patients had severe OSA. Our study showed a strong positive association between apnea hypopnea index (AHI) and mean continuous positive airway pressure (CPAP) pressure. It suggests that patients with higher AHI values generally require higher CPAP pressures. All three tests, SACS, STOP-Bang, and ESS, show statistically significant dependence, as indicated by the low P values (all <0.01). Conclusion: The study confirms that SACS, STOP-Bang, and ESS are all valuable tools in assessing the risk and severity of OSA, with each tool offering unique insights.