Effect of arterial blood bicarbonate (HCO3−) concentration on the accuracy of STOP-Bang questionnaire screening for obstructive sleep apnea

Pei, Chong Pei; Gui, Shuyu

doi:10.1186/s12890-021-01720-2

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…The SBQ is widely used in different populations due to its simplicity and high sensitivity (Nagappa et al, 2015). Existing studies have improved SBQ diagnosis performance, e.g., by combining the SBQ with arterial blood HCO 3 concentrations (Pei & Gui, 2021), alternative scoring models (Chung et al, 2014), the weighted STOP‐Bang (Nahapetian et al, 2016), a simplified version of the SBQ‐B‐APNEIC score (Morinigo et al, 2022)and a two‐step approach (Chung et al, 2016). However, there are few studies that have considered gender differences when using the SBQ.…”

Section: Introductionmentioning

confidence: 99%

Accuracy and modification of the STOP‐bang questionnaire for screening patients with obstructive sleep apnea in China

Wang

Zhao

Liang

et al. 2022

Journal of Sleep Research

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Summary Despite the high sensitivity of the STOP‐Bang questionnaire [snoring, tiredness, observed apneas, high blood pressure, body mass index, age, neck size, gender] questionnaire (SBQ), which is widely used to screen individuals at high risk of obstructive sleep apnea (OSA), few studies have evaluated the discrimination related to sex in the SBQ. Therefore, our study aimed to assess whether SBQ performance is gender‐related and modified by changing body mass index (BMI) and neck circumference (NC) cut‐off values. A total of 470 patients attended the sleep centres. They were divided into moderate‐to‐severe OSA and non‐moderate‐to‐severe OSA groups based on the apnea–hypopnea index (AHI) and the results of the SBQ screening. The predictive performance of the SBQ screening instrument was evaluated by 2 × 2 contingency tables and discriminatory ability, which was estimated from the area under the curve (AUC) obtained from receiver operating characteristic curve. Our results suggest that when screening for moderate‐to‐severe OSA, the original SBQ has higher sensitivity and lower specificity for men; however, women have higher specificity and lower sensitivity. The SBQ achieved the maximum AUC of 0.783 for men and 0.634 for women when the BMI cut‐off value was established at 30 kg/m2 and the NC cut‐off value was established at 38 cm in men, and the BMI cut‐off value was established at 25 kg/m2 and the NC cut‐off value at 36 cm in women. Balancing the optimal sensitivity and specificity, the cut‐off value of the optimal modified SBQ total scores for men was determined to be ≥4 and ≥3 for women.

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Section: Introductionmentioning

confidence: 99%

Accuracy and modification of the STOP‐bang questionnaire for screening patients with obstructive sleep apnea in China

Wang

Zhao

Liang

et al. 2022

Journal of Sleep Research

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“…Some studies have reported increased bicarbonate levels in OSA, in proportion to the apnea–hypopnea index ( Kaw et al, 2009 ; Chung et al, 2013 ; Eskandari et al, 2017 ; Pei and Gui, 2021 ), even in the absence of OHS ( Eskandari et al, 2017 ), in cohorts that were less likely to have OHS based on relatively low average BMIs ( Chung et al, 2013 ; Pei and Gui, 2021 ) and when comparing to BMI-matched controls ( Gold et al, 1993 ). OSA patients with frequent or long apneas may accumulate CO 2 during sleep ( Ayappa et al, 2002 ; Chung et al, 2013 ), leading to a compensatory increase of bicarbonate levels.…”

Section: Discussionmentioning

confidence: 99%

Effects of sex, age, and body mass index on serum bicarbonate

et al. 2023

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RationaleObesity hypoventilation syndrome (OHS) is often underdiagnosed, with significant morbidity and mortality. Bicarbonate, as a surrogate of arterial carbon dioxide, has been proposed as a screening tool for OHS. Understanding the predictors of serum bicarbonate could provide insights into risk factors for OHS. We hypothesized that the bicarbonate levels would increase with an increase in body mass index (BMI), since the prevalence of OHS increases with obesity.MethodsWe used the TriNetX Research Network, an electronic health record database with de-identified clinical data from participating healthcare organizations across the United States, to identify 93,320 adults without pulmonary or advanced renal diseases who had serum bicarbonate and BMI measurements within 6 months of each other between 2017 and 2022. We used linear regression analysis to examine the associations between bicarbonate and BMI, age, and their interactions for the entire cohort and stratified by sex. We also applied a non-linear machine learning algorithm (XGBoost) to examine the relative importance of age, BMI, sex, race/ethnicity, and obstructive sleep apnea (OSA) status on bicarbonate.ResultsThis cohort population was 56% women and 72% white and 80% non-Hispanic individuals, with an average (SD) age of 49.4 (17.9) years and a BMI of 29.1 (6.1) kg/m2. The mean bicarbonate was 24.8 (2.8) mmol/L, with higher levels in men (mean 25.2 mmol/L) than in women (mean 24.4 mmol/L). We found a small negative association between bicarbonate and BMI, with an expected change of −0.03 mmol/L in bicarbonate for each 1 kg/m2 increase in BMI (p < 0.001), in the entire cohort and both sexes. We found sex differences in the bicarbonate trajectory with age, with women exhibiting lower bicarbonate values than men until age 50, after which the bicarbonate levels were modestly higher. The non-linear machine learning algorithm similarly revealed that age and sex played larger roles in determining bicarbonate levels than the BMI or OSA status.ConclusionContrary to our hypothesis, BMI is not associated with elevated bicarbonate levels, and age modifies the impact of sex on bicarbonate.

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“…Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a disorder characterized by apnea, decreased respiration, and decreased oxygen saturation level due to collapse of the upper airway, manifested by daytime sleepiness, fatigue, and inattention ( Pei and Gui, 2021 ). The signs and symptoms of OSAHS and FM are similar.…”

Section: Introductionmentioning

confidence: 99%

“…The signs and symptoms of OSAHS and FM are similar. Treatment of FM is ineffective, and patients with FM often experience sleep problems, fatigue, and pain ( Oka et al, 2020 ; Pei and Gui, 2021 ). Moldofsky et al originally defined FM syndrome as musculoskeletal pain, fatigue, and sleep disturbances ( Moldofsky et al, 1975 ).…”

Section: Introductionmentioning

confidence: 99%

Fibromyalgia in obstructive sleep apnea-hypopnea syndrome: a systematic review and meta-analysis

He,

Chen,

Huang

et al. 2024

Front. Physiol.

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Introduction: Fibromyalgia (FM) is a common condition in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). This meta-analysis aimed to evaluate differences in sleep monitoring indicators between patients with OSAHS and positive FM and patients with OSAHS and negative FM and to determine the incidence of FM in patients with OSAHS.Methods: An exhaustive literature review was conducted to analyze the incidence of FM in patients with OSAHS, using online databases, including PubMed, EMBASE, Web of Science, CNKI, and Wanfang, both in English and Chinese. The quality of the included studies was assessed by two researchers using the Newcastle−Ottawa Scale scores. The acquired data were analyzed using Stata 11.0 software. Continuous variables were combined and analyzed using the weighted mean difference as the effect size. Conjoint analyses were performed using random-effects (I2 > 50%) or fixed-effect (I2 ≤ 50%) models based on I2 values.Results: Fourteen studies met the inclusion criteria. This study showed that 21% of patients with OSAHS experienced FM. Subgroup analyses were performed based on race, age, sex, body mass index, and diagnostic criteria for patients with OSAHS. These findings indicate that obese patients with OSAHS have a higher risk of FM, similar to females with OSAHS. Regarding most sleep monitoring indicators, there were no discernible differences between patients with OSAHS with positive FM and those with negative FM. However, patients with positive FM had marginally lower minimum arterial oxygen saturation levels than those with negative FM. The current literature suggests that patients with OSAHS have a high incidence of FM (21%), and FM has little effect on polysomnographic indicators of OSAHS.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024510786, identifier CRD42024510786

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Effect of arterial blood bicarbonate (HCO3−) concentration on the accuracy of STOP-Bang questionnaire screening for obstructive sleep apnea

Cited by 7 publications

References 30 publications

Accuracy and modification of the STOP‐bang questionnaire for screening patients with obstructive sleep apnea in China

Accuracy and modification of the STOP‐bang questionnaire for screening patients with obstructive sleep apnea in China

Effects of sex, age, and body mass index on serum bicarbonate

Fibromyalgia in obstructive sleep apnea-hypopnea syndrome: a systematic review and meta-analysis

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