Two-stage screening for obstructive sleep apnea in the primary practice setting

Pangerc, Andrej (author), Petek Šter, Marija (author), Dolenc-Grošelj, Leja (author)

Purpose To evaluate the effectiveness of a two-stage screening model for obstructive sleep apnea (OSA) in primary care that combines the STOP-BANG questionnaire (SBQ) with an automated home sleep apnea test (HSAT). Methods This cross-sectional study was conducted from August 2018 to August 2022 in four Slovenian primary care practices. It included 153 randomly selected patients aged 18 to 70 years who visited the practice for any reason. Participants completed the SBQ and underwent HSAT with type III polygraphy on the same night. The HSAT recordings were scored automatically and by an experienced, accredited somnologist. Results There was a strong correlation between manual and automated HSAT scorings for the detection of OSA (Pearson’s r = 0.93). Cohen’s kappa was 0.80 for OSA (respiratory event index (REI) ≥ 5) and 0.77 for OSA severity categorization. The two-stage model demonstrated sensitivity of 64%, a specificity of 97.4%, a positive predictive value (PPV) of 96.0%, a negative predictive value (NPV) of 73.8% and an accuracy of 81.1% for any OSA (REI ≥ 5). For moderate to severe OSA (REI ≥ 15), the model showed 72.7% sensitivity, 96.7% specificity, 85.7% PPV, 92.8% NPV and 91.5% accuracy. Conclusions The two-stage model for OSA screening combining the SBQ and automated HSAT was shown to be effective in primary care, especially for moderate and severe OSA. This method provides a practical and efficient approach for the early detection of OSA.

• Language: English
• Keywords: family medicine, obstructive sleep apnea, primary practice setting, STOP-BANG questionnaire, home sleep apnoea testing, HSAT, two-stage screening
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2024
• Number of pages: Str. 2531-2538
• Numbering: Vol. 28, iss. 6
• PID: 20.500.12556/RUL-179121
• ISSN on article: 1522-1709
• DOI: 10.1007/s11325-024-03142-w
• COBISS.SI-ID: 267989507
• Publication date in RUL: 05.02.2026

Record is a part of a journal

• Title: Sleep and breathing
• Publisher: Springer Nature
• ISSN: 1522-1709
• COBISS.SI-ID: 3133716

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Projects

• Funder: ARRS - Slovenian Research Agency
• Project number: P3-0338
• Name: Fiziološki mehanizmi nevroloških motenj in bolezni