Clinical Adult Literature Updates from July 2014

Positional OSA Part 1: Towards a Clinical Classification System for Position-Dependent Obstructive Sleep Apnoea

In 1984, Cartwright suggested that physicians should differentiate between patients with either positional obstructive sleep apnoea (POSA) or non-positional OSA. He introduced the arbitrary cut-off point of a difference of 50 % or more in apnoea index between supine and non-supine positions. In this study, a panel of three field experts developed consensus on Amsterdam Positional OSA Classification resulting in the consensus standard used to calibrate the new classification.

Obstructive Sleep Apnea and Severe Maternal-Infant Morbidity/Mortality in the United States, 1998–2009

OSA was associated with increased odds of pregnancy-related morbidities including preeclampsia (OR, 2.5; 95% CI, 2.2–2.9), eclampsia (OR, 5.4; 95% CI, 3.3–8.9), cardiomyopathy (OR, 9.0; 95% CI, 7.5–10.9), and pulmonary embolism (OR, 4.5; 95% CI, 2.3–8.9). Women with OSA experienced a more than fivefold increased odds of in-hospital mortality (95% CI, 2.4–11.5). Obstructive sleep apnea is associated with severe maternal morbidity, cardiovascular morbidity, and in-hospital death.

Association Between a Positive Screen on the STOP-BANG Obstructive Sleep Apnea Tool and Preeclampsia

In pregnancy, a positive screen on the STOP-BANG Questionnaire was associated with preeclampsia. Future studies are needed to validate the performance of this tool against polysomnography during pregnancy, which most participants stated they would be willing to complete

Validation of the STOP-BANG Questionnaire Among Patients Referred for Suspected Obstructive Sleep Apnea

A STOP-BANG in which all information is self-reported may be as effective as the original version, and has potential to facilitate research or community screening where good negative predictive value is required for an effective screening tool.

Value of STOP-Bang Questionnaire in Screening Patients With Obstructive Sleep Apnea Hypopnea Syndrome in Sleep Disordered Breathing Clinic

The STOP-Bang questionnaire has excellent sensitivity in screening OSAHS patients and can predict the severity of OSAHS. More studies will be required to determine the value of SBQ in the general Chinese population.