Abstract：
OBJECTIVE: Obstructive sleep apnea (OSA) is a prevalent condition among electable to bariatric surgery obese patients, often remaining underdiagnosed, thereby increasing surgical risk. The main purpose was to determine prevalence of OSA among candidates for bariatric surgery and to assess the rate of underdiagnosis of this condition. Additionally, the study aimed to evaluate the specific performance of three sleep questionnaires and scales (Excessive Daytime Sleepiness Scale (EDSS), Epworth Sleepiness Scale (ESS), and STOP-Bang) in these patients.
METHODS: A longitudinal, prospective, single-cohort study, with consecutive sampling including patients aged 18-65 years with obesity grade II (body mass index (BMI) ≥ 35 kg/m2) and hypertension, type 2 diabetes, metabolic syndrome or OSA or obesity grade III or IV (BMI ≥ 40 kg/m2) elective for bariatric surgery. Patients were evaluated at the Otorhinolaryngology department with an anamnesis regarding OSA including the administration of three sleep questionnaires (EDSS, ESS, and STOP-Bang), followed by cardiorespiratory polygraphy (CRP) for sleep evaluation.
RESULTS: 124 patients were included in this study. While 74.2% of the sample exhibited OSA on CRP, only 28.2% had a prior diagnosis. The STOP-Bang questionnaire demonstrated the highest sensitivity (93.3%) for detecting moderate to severe OSA, although with low specificity (33.8%). EDSS and ESS did not show a significant association with the presence of OSA.
CONCLUSIONS: OSA screening is crucial in candidates for bariatric surgery due to its high prevalence and low diagnosis rate. The STOP-Bang questionnaire may serve as a useful tool for identifying patients at risk of moderate to severe OSA and optimizing sleep assessments. However, further research is necessary to validate its utility in this specific population.
METHODS: A longitudinal, prospective, single-cohort study, with consecutive sampling including patients aged 18-65 years with obesity grade II (body mass index (BMI) ≥ 35 kg/m2) and hypertension, type 2 diabetes, metabolic syndrome or OSA or obesity grade III or IV (BMI ≥ 40 kg/m2) elective for bariatric surgery. Patients were evaluated at the Otorhinolaryngology department with an anamnesis regarding OSA including the administration of three sleep questionnaires (EDSS, ESS, and STOP-Bang), followed by cardiorespiratory polygraphy (CRP) for sleep evaluation.
RESULTS: 124 patients were included in this study. While 74.2% of the sample exhibited OSA on CRP, only 28.2% had a prior diagnosis. The STOP-Bang questionnaire demonstrated the highest sensitivity (93.3%) for detecting moderate to severe OSA, although with low specificity (33.8%). EDSS and ESS did not show a significant association with the presence of OSA.
CONCLUSIONS: OSA screening is crucial in candidates for bariatric surgery due to its high prevalence and low diagnosis rate. The STOP-Bang questionnaire may serve as a useful tool for identifying patients at risk of moderate to severe OSA and optimizing sleep assessments. However, further research is necessary to validate its utility in this specific population.
摘要：
目的：阻塞性睡眠呼吸暂停（OSA）是可选择的减肥手术肥胖患者中普遍存在的疾病，经常被诊断不足，从而增加手术风险。主要目的是确定减肥手术候选人中OSA的患病率，并评估这种疾病的低诊断率。此外,本研究旨在评估三种睡眠问卷和量表的具体表现(白天过度嗜睡量表(EDSS)，Epworth嗜睡量表（ESS），和STOP-Bang)在这些患者中。
方法：纵向，prospective,单队列研究，连续抽样包括18-65岁肥胖II级（体重指数（BMI）≥35kg/m2）和高血压的患者，2型糖尿病,代谢综合征或OSA或肥胖III级或IV级（BMI≥40kg/m2）选择减肥手术。在耳鼻喉科对患者进行了有关OSA的回忆，包括进行三份睡眠问卷（EDSS，ESS,和STOP-Bang)，然后用心肺多谱分析（CRP）进行睡眠评估。
结果：124例患者纳入本研究。虽然74.2%的样本在CRP上表现为OSA，只有28.2%的人有过诊断.STOP-Bang问卷显示出检测中度至重度OSA的最高敏感性（93.3％），尽管特异性低（33.8%）。EDSS和ESS与OSA的存在没有显著关联。
结论：OSA筛查对减肥手术的候选患者至关重要，因为其高患病率和低诊断率。STOP-Bang问卷可以作为识别处于中度至重度OSA风险的患者和优化睡眠评估的有用工具。然而,需要进一步的研究来验证其在这一特定人群中的效用。
方法：纵向，prospective,单队列研究，连续抽样包括18-65岁肥胖II级（体重指数（BMI）≥35kg/m2）和高血压的患者，2型糖尿病,代谢综合征或OSA或肥胖III级或IV级（BMI≥40kg/m2）选择减肥手术。在耳鼻喉科对患者进行了有关OSA的回忆，包括进行三份睡眠问卷（EDSS，ESS,和STOP-Bang)，然后用心肺多谱分析（CRP）进行睡眠评估。
结果：124例患者纳入本研究。虽然74.2%的样本在CRP上表现为OSA，只有28.2%的人有过诊断.STOP-Bang问卷显示出检测中度至重度OSA的最高敏感性（93.3％），尽管特异性低（33.8%）。EDSS和ESS与OSA的存在没有显著关联。
结论：OSA筛查对减肥手术的候选患者至关重要，因为其高患病率和低诊断率。STOP-Bang问卷可以作为识别处于中度至重度OSA风险的患者和优化睡眠评估的有用工具。然而,需要进一步的研究来验证其在这一特定人群中的效用。
