Diagnostic Accuracy of the Multivariable Apnea Prediction (MAP) Index as a Screening Tool for Obstructive Sleep Apnea
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Abstract
Background and Objective: Obstructive sleep apnea (OSA) is the most common type of sleep-disordered breathing. Multivariable apnea prediction (MAP) index consists of three questions about the frequency of OSA symptoms plus body mass index (BMI), age and sex that categorizes the patients to low and high risk for OSA using a formula. Objective MAP index was calculated by discounting the questions from formula. In this study, we evaluated the utility of the MAP index and objective MAP index in screening of the OSA.
Materials and Methods: In a cross-sectional study, we enrolled 609 patients of three sleep clinics suspected of having OSA who underwent polysomnography (PSG) as a gold standard test for OSA diagnosis. The apnea-hypopnea index (AHI) of the PSG was used to classify the severity of OSA.
Results: A significant strong correlation was observed between MAP index and objective MAP index using Spearman’s coefficient (r=0.801, P<0.001). Spearman’s correlation coefficient showed a stronger correlation between AHI and MAP index (r=0.586, P<0.001) than between AHI and objective MAP index (r=0.467, P<0.001). The area under the curve of the MAP index and objective MAP index were found to be 0.810 and 0.766, respectively, at AHI≥5; 0.792 and 0.728, respectively, at AHI≥15, and 0.767 and 0.684, respectively, at AHI≥30. The predictive parameters of the MAP index and objective MAP index for identifying OSA were satis- factory.
Conclusions: This study showed that MAP index and especially objective MAP index might have a consid- erable utility in the screening of OSA.
Kryger MH. Diagnosis and management of sleep apnea syndrome. Clin Cornerstone 2000;2:39-47.
Young T, Palta M, Dempsey J, Skatrud J, We- ber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230-5.
Mulgrew AT, Nasvadi G, Butt A, et al. Risk and severity of motor vehicle crashes in patients with obstructive sleep apnoea/hypopnoea. Thorax 2008;63:536-41.
Philip P. Sleepiness of occupational drivers. Ind Health 2005;43:30-3.
Gurubhagavatula I, Maislin G, Nkwuo JE, Pack AI. Occupational screening for obstructive sleep ap- nea in commercial drivers. Am J Respir Crit Care Med 2004;170:371-6.
Talmage JB, Hudson TB, Hegmann KT, Thiese MS. Consensus criteria for screening commercial drivers for obstructive sleep apnea: evidence of effi-cacy. J Occup Environ Med 2008;50:324-9.
Maislin G, Pack AI, Kribbs NB, et al. A survey screen for prediction of apnea. Sleep 1995;18:158-66.
Practice parameters for the indications for poly- somnography and related procedures. Polysomnogra-phy Task Force, American Sleep Disorders Associa- tion Standards of Practice Committee. Sleep 1997;20:406-22.
Medicine AAoS, Iber C. The AASM manual for the scoring of sleep and associated events: rules, ter- minology and technical specifications: American Academy of Sleep Medicine; 2007.
Tzischinsky O, Cohen A, Doveh E, et al. Screening for sleep disordered breathing among ap- plicants for a professional driver's license. J Occup Environ Med 2012;54:1275-80.
Sadeghniiat Haghighi K, Montazeri A, KhajehMehrizi A, et al. The Epworth Sleepiness Scale: translation and validation study of the Iranian ver- sion. Sleep Breath 2013;17:419-26.
Aldrich MS. Automobile accidents in patients with sleep disorders. Sleep 1989;12:487-94.
George CF, Smiley A. Sleep apnea & automo- bile crashes. Sleep 1999;22:790-5.
Shiomi T, Arita AT, Sasanabe R, et al. Falling asleep while driving and automobile accidents among patients with obstructive sleep apnea-hypopnea syn- drome. Psychiatry Clin Neurosci 2002;56:333-4.
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| Issue | Vol 1 No 1 (2016): Winter | |
| Section | Original Article(s) | |
| Keywords | ||
| Multivariable apnea prediction index Screening Obstructive sleep apnea | ||
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