Anthropometric screening approach for obstructive sleep apnea in Japanese men: development and validation of the ABC scale

Abstract

Abstract Background The existing screening tools for the detection of moderate and severe obstructive sleep apnea (OSA) are tailored to Western individuals. The aim of this study was to formulate and validate a simple anthropometric tool for OSA screening in a Japanese male population by incorporating objective indicators obtained during routine medical checkups. Methods In total, 443 Japanese men, who were suspected of having OSA and visited our sleep disorder clinic from 2009 to 2012, were retrospectively divided into two groups (developmental group [DG], n = 206; validation group [VG], n = 237). In DG, OSA was defined as an apnea-hypopnea index of ≥ 15 events/h. Data regarding clinical and anthropometric variables (age, body mass index [BMI], neck circumference [NC], waist circumference [WC]) were obtained. For parameters that were associated with OSA on simple logistic regression analysis, cutoff values were calculated with receiver operating characteristic curves to create a new screening tool. The utility of the tool was evaluated in VG and compared to that of the modified Berlin questionnaire (mBQ) for OSA. Results Age (odds ratio [OR] = 1.033, p = 0.002), BMI (OR = 1.231, p < 0.001), NC (OR = 1.327, p < 0.001), and WC (OR = 1.083, p < 0.001) were statistically significant risk factors for OSA in DG. Cutoff values for the prediction of OSA were age: ≥46.5 years, BMI: ≥25.45 kg/m2, NC: ≥38.35 cm, and WC: ≥90.75 cm. Our screening tool, incorporating age, BMI, and WC, yielded 70.1% sensitivity (mBQ: 85.4%) and 66.0% specificity (mBQ: 35.0%) in VG. Conclusions OSA screening in Japanese men has been conducted only in limited settings such as sleep clinics. It is hoped that this study will promote screening using objective indices in medical checkups and enable early detection and treatment of OSA.