Sleep Disorders |

Neck Circumference Sensitivity and Specificity to Predict Obstructive Sleep Apnea Syndrome FREE TO VIEW

Stefan Mihaicuta, MD; Izabella Anita Toth, BS; Sorin Paralescu, MD
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University of Medicine and Pharmacy, Timisoara, Romania

Chest. 2014;145(3_MeetingAbstracts):588A. doi:10.1378/chest.1824321
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SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: A cross-sectional review was performed in order to assess the ability of the neck circumference (NC) to predict the diagnosis of obstructive sleep apnoea syndrome (OSAS) in a population group from Timisoara, Romania.

METHODS: We included 836 consecutive adult male patients ( 18 years old) referred to Victor Babes Timisoara sleep lab to be polysomnographic (PSG) evaluated for OSAS between October 2005 and April 2013. At initial visit anthropometric data, including NC, were recorded. With the area under curve (AUC) derived from the receiver-operating characteristic (ROC) curve we assessed the classification ability of the NC for the diagnostic of OSAS. Sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV), positive likelihood ratio (LR+) and negative likelihood ratio (LR-) were calculated for different cut-off points.

RESULTS: Age range was 19 - 83 years (median 52, interquartile range 42 - 60), NC range was 30 - 62 cm (median 45, interquartile range 42 - 47). 778 (93.1%) patients were diagnosed with OSAS as determined by PSG, with apnoea - hypopnea index (AHI)>5 events/hour of sleep. The median AHI was 38.75/h (interquartile range 22.85 - 57.71). A significant correlation was found between NC and AHI (ρ=0.35, p<0.001). The AUC of 0.71 (95% CI 0.63-0.79, p<0.001) indicates that 71% of OSAS diagnosed subjects had a higher NC than subjects with no OSAS. The optimal NC was 41 cm with a sensitivity of 0.8099, specificity of 0.5185, PPV of 0.9588 and NPV of 0.1647. The LR+ was 1.68 indicating that a male patient with NC>41cm is 1.68 times more likely to have OSAS than one with NC below this cut-off point.

CONCLUSIONS: Neck circumference is easy to obtain and does not imply additional costs. Our study confirms that the NC is a reliable measurement in patients suspected to have OSAS on a population referred to a sleep lab. Patients with NC >41cm, especially men, should have a priority for the overnight sleep study.

CLINICAL IMPLICATIONS: A simple measurement for selection of patients from a waiting list of a sleep laboratory

DISCLOSURE: The following authors have nothing to disclose: Stefan Mihaicuta, Izabella Anita Toth, Sorin Paralescu

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