SESSION TITLE: Diagnosis of Sleep Apnea
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Monday, October 27, 2014 at 07:30 AM - 08:30 AM
PURPOSE: Sleep disorders are highly prevalent, disabling and often not recognized in primary care settings. We developed SNORE, a branching logic, computerized sleep disorder screening questionnaire that is self-administered and identifies patients at risk for Obstructive Sleep Apnea (OSA), Restless legs syndrome (RLS), Insomnia, Sleep deprivation (SD), and other common sleep disorders. A comparison of SNORE to a sleep medicine clinician’s risk assessment was conducted in the North Shore LIJ Sleep Disorders Center.
METHODS: An IRB approved prospective crossover trial compared SNORE’s risk assessment to the “gold standard” trained sleep medicine clinician’s differential diagnosis to establish the feasibility of SNORE as a screening tool. Patients were enrolled from those referred to the sleep center (n=50) and primary care clinic (n=10). They completed both SNORE and an interview by a sleep physician who was blinded to the patients’ histories and survey results. A preliminary analysis of data from the first 60 patients is provided below.
RESULTS: Our analysis demonstrated that SNORE was highly sensitive and specific for Obstructive Sleep Apnea (OSA), insomnia, Restless leg syndrome (RLS) and Sleep deprivation (SD) compared to the gold standard interview with a sleep clinician. In addition, ROC analyses showed SNORE to be accurate. The median completion time of SNORE was 3.8 minutes compared to 6.2 minutes for the interviewer. Sensitivity; Specificity; AUC; P-Value for each diagnosis, SNORE vs. Sleep Clinician Differential Diagnosis OSA: 92%; 64%; 78%; 0.0001 Insomnia: 100%; 69%; 84%; < 0.0001 RLS: 91%; 78%; 85%; < 0.0001 SD: 84%; 70%; 77%; < 0.0001
CONCLUSIONS: SNORE may be an efficient method of screening for a variety of sleep disorders. Further research is required to test SNORE in the primary care clinic in larger numbers.
CLINICAL IMPLICATIONS: If validated SNORE would have utility in identifying sleep disorders in the primary care setting.
DISCLOSURE: The following authors have nothing to disclose: Harly Greenberg, Michael Morgenstern, Alexandra MacSaveny, Thomas Batemarco, Kelly-Ann Mungroo, Montserrat Del Olmo, Rachel Schottenfeld
We developed SNORE, a branching logic, computerized sleep disorder screening questionnaire that is self-administered and identifies patients at risk for sleep disorders.