SEATTLE — Patients with heart failure or hypertension who answered “Yes” to at least two of three questions had a high likelihood of having obstructive sleep apnea, Cheryl L. Bartone reported in a poster presentation at the annual meeting of the Heart Failure Society of America.
Ms. Bartone and her associates compared responses to the screening questionnaire with polysomnography results (the preferred method for diagnosing obstructive sleep apnea) in 70 outpatients with heart failure or hypertension seen a cardiology office. The three-question tool was 90% sensitive and 45% specific in detecting obstructive sleep apnea, said Ms. Bartone of the Ohio Heart and Vascular Center, Cincinnati. The tool had a positive predictive value of 67% and a negative predictive value of 78%. Patients were asked:
▸ Do you snore loudly?
▸ Do you wake up more than once a night?
▸ Do you have morning fatigue?
Polysomnograms showed that 67 patients had some degree of obstructive sleep apnea, defined as an apnea-hypopnea index of 5 or greater. The obstructive sleep apnea was considered significant in 39 patients who had moderate or severe obstructive sleep apnea, defined as an apnea-hypopnea index of 20 or greater.
Of the 52 patients who answered “Yes” to at least two questions, 32 had significant obstructive sleep apnea. Of the 18 who answered “Yes” to only one or none of the questions, 4 had significant obstructive sleep apnea. Patients with significant obstructive sleep apnea were more likely to be on β-blockers than were those without significant obstructive sleep apnea (82% vs. 74%) and were less likely to be on an ACE inhibitor or angiotensin receptor blocker (74% vs. 77%). The investigators have no financial conflicts of interest in the study.