High prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls

Purpose: Undiagnosed obstructive sleep apnoea (OSA) in the community makes comparisons of OSA subjects with control samples from the general population problematic. This study aims to estimate undiagnosed moderate to severe OSA in a general population sample and to determine the capacity of question...

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Main Authors: Simpson, L., Hillman, D., Cooper, M., Ward, K., Hunter, M., Cullen, S., James, A., Palmer, L., Mukherjee, S., Eastwood, Peter
Format: Journal Article
Published: 2013
Online Access:http://hdl.handle.net/20.500.11937/19213
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author Simpson, L.
Hillman, D.
Cooper, M.
Ward, K.
Hunter, M.
Cullen, S.
James, A.
Palmer, L.
Mukherjee, S.
Eastwood, Peter
author_facet Simpson, L.
Hillman, D.
Cooper, M.
Ward, K.
Hunter, M.
Cullen, S.
James, A.
Palmer, L.
Mukherjee, S.
Eastwood, Peter
author_sort Simpson, L.
building Curtin Institutional Repository
collection Online Access
description Purpose: Undiagnosed obstructive sleep apnoea (OSA) in the community makes comparisons of OSA subjects with control samples from the general population problematic. This study aims to estimate undiagnosed moderate to severe OSA in a general population sample and to determine the capacity of questions from the Berlin questionnaire (BQ) to identify subjects without diagnosed OSA of this severity. Methods: Using a general population sample (n0793) with no history of OSA, case and control status for moderate- severe OSA was determined by home-based nasal flow and oximetry-derived apnoea-hypopnoea index using a cut-off value of =15 events/h to define cases. The diagnostic accuracy of the complete BQ and its component questions in identifying cases was assessed by calculating sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios and post-test probabilities. Results: The age-standardised prevalence estimate of moderate- severe OSA was 9.1 % (12.4 % in men, 5.7 % in women). Sensitivity of the BQ in this population was 54 %, and specificity, 70 %. A combination of questions regarding snoring frequency and hypertension provided maximal post-test probability of OSA and greatest post-screen sample size. Conclusions: Undiagnosed OSA is highly prevalent in the Western Australian general population. While the complete BQ is a sub-optimal screening instrument for the general population, snoring frequency or hypertension can be used to screen out moderate-severe OSA from general population samples with limited reduction in sample size. As there are few general population samples available for epidemiological or genetic studies of OSA and its associated phenotypes, these results may usefully inform future case-control studies.
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spelling curtin-20.500.11937-192132017-09-13T13:46:47Z High prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls Simpson, L. Hillman, D. Cooper, M. Ward, K. Hunter, M. Cullen, S. James, A. Palmer, L. Mukherjee, S. Eastwood, Peter Purpose: Undiagnosed obstructive sleep apnoea (OSA) in the community makes comparisons of OSA subjects with control samples from the general population problematic. This study aims to estimate undiagnosed moderate to severe OSA in a general population sample and to determine the capacity of questions from the Berlin questionnaire (BQ) to identify subjects without diagnosed OSA of this severity. Methods: Using a general population sample (n0793) with no history of OSA, case and control status for moderate- severe OSA was determined by home-based nasal flow and oximetry-derived apnoea-hypopnoea index using a cut-off value of =15 events/h to define cases. The diagnostic accuracy of the complete BQ and its component questions in identifying cases was assessed by calculating sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios and post-test probabilities. Results: The age-standardised prevalence estimate of moderate- severe OSA was 9.1 % (12.4 % in men, 5.7 % in women). Sensitivity of the BQ in this population was 54 %, and specificity, 70 %. A combination of questions regarding snoring frequency and hypertension provided maximal post-test probability of OSA and greatest post-screen sample size. Conclusions: Undiagnosed OSA is highly prevalent in the Western Australian general population. While the complete BQ is a sub-optimal screening instrument for the general population, snoring frequency or hypertension can be used to screen out moderate-severe OSA from general population samples with limited reduction in sample size. As there are few general population samples available for epidemiological or genetic studies of OSA and its associated phenotypes, these results may usefully inform future case-control studies. 2013 Journal Article http://hdl.handle.net/20.500.11937/19213 10.1007/s11325-012-0785-0 restricted
spellingShingle Simpson, L.
Hillman, D.
Cooper, M.
Ward, K.
Hunter, M.
Cullen, S.
James, A.
Palmer, L.
Mukherjee, S.
Eastwood, Peter
High prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls
title High prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls
title_full High prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls
title_fullStr High prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls
title_full_unstemmed High prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls
title_short High prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls
title_sort high prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls
url http://hdl.handle.net/20.500.11937/19213