ASSESSING THE ADJUSTED NECK CIRCUMFERENCE SLEEP APNEA SCREENING SCORE IN PATIENTS CLINICALLY SUSPECTED TO BE AT HIGH RISK OF OBSTRUCTIVE SLEEP APNEA

MedStar-Georgetown University Hospital, Washington, DC

PURPOSE: To validate the adjusted neck circumference score as an effective screening tool for patients clinically suspected to have obstructive sleep apnea (OSA) in conjunction with our in-hospital screening.

METHODS: All patients referred to our Sleep Lab were screened using the adjusted neck circumference screening score. This consists of four measures including: neck circumference (cm=#points), history of hypertension (4 points), history of snoring (3 points), and history of night-time choking or gasping (3 points). This is compared to the results of the sleep study.

RESULTS: 251 patients (154 males, 97 females) were screened. 220 patients (87.6%) were found to have OSA and 31 (12.4%) did not. Of the 220 patients found to have OSA (AHI>5), 144 (65.5%) were male and 76 (34.5%) were female. Table 1 summarizes the differences between the groups with and without OSA. Patients with OSA were more likely to be older (p<.0001), have a larger BMI (p<.0001), and a higher screening score (p<.0001). The ESS was not significantly different in any respect. Table 2 summarizes the results of the two OSA severity groups: mild OSA (AHI > 5, <20) and moderate-severe OSA (AHI > 20). Patients with moderate-severe OSA were more likely to have a higher screening score(p<.0001), however, there was no significant difference in the BMI (except in males) and ESS. 37.8% of patients with mild OSA had a score > 48, 56.6% with moderate-severe OSA had a score > 48, 70.9% with severe OSA (AHI>50) had score > 48. 86.5% of males with severe OSA had a score > 48.

CONCLUSION: The adjusted neck circumference screening score is significantly higher in patients with OSA.

CLINICAL IMPLICATIONS: Screening tools have limitations. This was an attempt to validate a simple screening score for OSA in our sleep lab population that can be further applied to screening adult inpatients.

DISCLOSURE: Christopher Wyckoff, No Financial Disclosure Information; No Product/Research Disclosure Information

According to CHEST Journal.