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Abstract

Diagnostic Value of the Morphometric Model and Adjusted Neck Circumference in Adults with Obstructive Sleep Apnea Syndrome

VOLUME 67 - NUMBER 4 / July - August (Original articles)

Armando Castorena-Maldonado, Sleep Disorders Clinic, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, México, D.F., México
Laura Espinosa-Morett, Department of Otorhinolaryngology, Head and Neck Surgery, Instituto Nacional de Rehabilitación, México, D.F., México
Fernando Arredondo del Bosque, Department of Otorhinolaryngology, Head and Neck Surgery, Instituto Nacional de Rehabilitación, México, D.F., México
José Luis Carrillo-Alduenda, Sleep Disorders Clinic, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, México, D.F., México
Luis Torre-Bouscoulet, Department of Respiratory Physiology, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas and Laboratorio de Función Pulmonar S de RL, Mexico City, Mexico
Juan Carlos Vázquez-García, Sleep Disorders Clinic, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, México, D.F., México
José R. Pérez-Padilla, Department of Research on Smoking and COPD, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, SSA, Mexico City, Mexico

Background: Obstructive sleep apnea syndrome is a major public health problem. The morphometric model and the Sleep Apnea Clinical Score are widely used to evaluate adults; however, neither of these tools has been validated in a Mexican population. Objective: To determine the diagnostic value of the morphometric model and the Sleep Apnea Clinical Score and compare them with conventional clinical instruments. Methods: A total of 97 individuals were recruited prospectively. Initial screening excluded 36, of whom nine were subjects without apnea; the remaining 52 were consecutive patients with obstructive sleep apnea syndrome diagnosed by nocturnal polysomnography. Diagnostic values of each test were calculated. Results: Obstructive sleep apnea syndrome patients had significantly higher scores with both instruments than controls: morphometric model: 61.3 (95% CI: 45.5-75.3) vs. 41.0 (95% CI: 35.6-45.6); Sleep Apnea Clinical Score: 45.3 (95% CI: 39.5-40.3) vs. 36 (95% CI: 34.0-36.5), respectively. For severe cases, the best cutoff point for morphometric model was 46, with a sensitivity of 81% (95% CI: 62.5-92.6) and specificity of 46.7% (95% CI: 66.4-100), while for Sleep Apnea Clinical Score it was > 48, with a sensitivity of 61% (95% CI: 46.1-74.2) and specificity of 80.4% (95% CI: 66-90.6). Conclusions: A morphometric model value of ≥ 46 or an adjusted neck circumference (Sleep Apnea Clinical Score) > 48 were adequate for diagnosing obstructive sleep apnea syndrome.

Keywords: Obstructive sleep apnea syndrome. Morphometric model. Sleep apnea. Clinical scores.

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