Incorporating neck circumference or neck-to-height ratio into the GOAL questionnaire to better detect and describe obstructive sleep apnea with application to clinical decisions

Abstract

ObjectiveAlthough neck circumference (NC) and neck-to-height ratio (NHR) have been recognized as effective predictors of the clinical diagnosis of adult obstructive sleep apnea (OSA), they have not been included in the widely used GOAL questionnaire. Not coincidentally, the NHR has not been adequately considered in the development and validation of the STOP-Bang questionnaire, No-Apnea score and the NoSAS score. The motivation for the study was (1) to combine the GOAL questionnaire with the NC and NHR, respectively, to evaluate its predictive performance and (2) to compare it with the STOP-Bang questionnaire, the No-Apnea score, the NOSAS score, and the GOAL questionnaire.Materials and methodsThis retrospectively allocated cross-sectional study was conducted from November 2017 to March 2022 in adults who underwent nocturnal polysomnography (PSG) or home sleep apnea testing (HSAT). In this paper, the GOAL questionnaire was combined with the NC and NHR, respectively, using logistic regression. The performance of the six screening tools was assessed by discriminatory ability [area under the curve (AUC) obtained from receiver operating characteristic (ROC) curves] and a 2 × 2 league table [including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR−)] and compared under AHI ≥5/h, AHI ≥15/h, and AHI ≥30/h conditions.ResultsA total of 288 patients were enrolled in the study. For all severity OSA levels, the sensitivity of GOAL+NC ranged from 70.12 to 70.80%, and specificity ranged from 86.49 to 76.16%. The sensitivity of GOAL+NHR ranged from 73.31 to 81.75%, while specificity ranged from 83.78 to 70.86%. As for area under the curve (AUC) value under ROC curve, when AHI ≥5/h, compared with GOAL (0.806), No-Apnea (0.823), NoSAS (0.817), and GOAL+NC (0.815), GOAL+NHR (0.831) obtained the highest AUC value, but lower than STOP-Bang (0.837).ConclusionThe predictive power of incorporating NC or NHR into the GOAL questionnaire was significantly better than that of the GOAL itself. Furthermore, GOAL+NHR was superior to GOAL+NC in predicting OSA severity and better than the No-Apnea score and the NoSAS score.

The Relationships between Various Factors and Sleep Status: A Cross-Sectional Study among Healthy Saudi Adults

“…These symptoms, in turn, may disturb sleep and reduce its duration. A large NC is a recognized risk factor for obstructive sleep apnea [ 48 , 49 ]. Similar to our results, other studies did not find an association between NC and sleep quality [ 50 , 51 ] due to small sample sizes and other confounding factors [ 50 ].…”

Сlinical Characteristics of Children and Adolescents With Metabolic Syndrome in Kyiv

“…Âèçíà÷àâñÿ ïîêàçíèê WtHR, ÿê ñï³ââ³äíîøåííÿ îêðóaeíîñò³ òà볿 äî çðîñòó. Îñê³ëüêè âñå á³ëüøå äîñë³äaeåíü âêàçóþòü ïðî âçàºìîçâ'ÿçîê îêðóaeíîñò³ øè¿ (ÎØ) ³ç àïíîå ñíó ó ä³òåé [14,15] -23,8% (n=25), ó áàáö³ ïî ìàìèí³é ë³í³¿ -22,9% (n=24) òà ìàòåð³ -18,1% (n=19). Îaeèð³ííÿ ÷àñò³øå âñüîãî ñïîñòåð³ãàëîñü ó ìàòåð³ -13,3% (n=14) òà áàòüêà -10,5% (n=11).…”

“…WHtR was calculated as the ratio of waist circumference to height. As a growing number of studies have shown an association between neck circumference (NC) and sleep apnoea in children [14,15], all children with MetS had their NC measured in the supine and standing positions to assess the risk of apnoea. A detailed history and the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) were used to assess subjective daytime sleepiness in relation to sleep disorders such as obstructive sleep apnoea and/or sleep fragmentation.…”