Avaliação do Sleep Apnea Clinical Score, do Questionário de Berlim e da Escala de Sonolência de Epworth como preditores da Síndrome de Apneia Obstrutiva do Sono em pacientes com Doença Pulmonar Obstrutiva Crônica

Abstract

Sleep Apnea Clinical Score (SACS) and Berlin Questionnaire (BQ) are used to predict the likelihood of Obstructive Sleep Apnea Syndrome (OSAS) and Epworth Sleepiness Scale (ESS) is used to assess daytime sleepiness, a common OSA symptom. These clinical tools help prioritize individuals with the most severe illness to perform polysomnography. It is necessary to check the applicability of these tools in COPD subjects. The aim of this study was to compare BQ, SACS and ESE performance in predicting OSAS in COPD patients. SACS, BQ and ESS were applied to 91 COPD subjects. From this group, 24 underwent polysomnography. In this transversal study, these three tests were compared regarding their likelihood to predict OSAS in COPD subjects using receiver-operating curve (ROC) statistics. In this sample, 58 were men (63,7%) and the mean age was 69,4 ± 9,6 years-old. Fourteen subjects (15,4%) had high probability of OSA by SACS, 32 (32,5%) were considered as having high probability by BQ and 37 (40,7%) had excessive diurnal somnolence by ESS. From the 24 subjects who underwent polysomnography, OSAS diagnosis was confirmed in five (20,8%), according American Academy of Sleep Medicine criteria. BQ and ESS did not accurately predict OSA in this group of COPD subjects, with ROC area under the curves (AUC) of 0,54 (CI95%: 0,329-0,74, p = 0,75) and 0.69 (CI95%: 0,470-0,860, p = 0,10), respectively. SACS performance was significantly better, with AUC of 0.82 (CI95%: 0,606-0,943, p = 0,02). SACS was better than BQ and ESS in predicting OSAS in this group of COPD subjects, being useful for screening these patients for polysomnography.