Muhammad Usman Ullah, Jawad Khaliq Ansari, Sajid Mustafavi, Raheel Iftikhar, Waseem Raja, Wasib Husssain Shah, Sohail Khan Raja.
The effect of adding body mass index (BMI) and neck circumference to epworth sleepiness scale (ESS) for diagnosing obstructive sleep apnea hypopnea syndrome in sleep clinics.
Pak Armed Forces Med J Jan ;66(1):57-61.

Objective: To study the effect of adding body mass index and neck circumference to Epworth Sleepiness Scale (ESS) for diagnosing obstructive sleep apnea hypopnea syndrome in sleep clinics. Study Design: Cross sectional validation study. Place and Duration of Study: Department of Pulmonology, Military Hospital Rawalpindi from 1st July 2013 to 01 September 2014. Material and Methods: The ESS and ESS plus body mass index (BMI) and neck circumference (NC) data was evaluated for 150 patients hospitalized in our hospital for polysomnographic evaluation of obstructive sleep apnea. Overnight polysomnography (PSG) was done for all patients and was considered the gold standard for diagnosis of OSA. ESS Scoring, BMI and NC data was done using pre-designated questionnaire. All the data was analyzed using SPSS version 19. Results: Age ranged from 18-74 years with mean age of the study group 53 (±12.1 SD) years. Out of study population 87 (58%) were males and 63 (42%) females. In study population 80 (55.3%) patients had ESS >10. while 102 patients had ESS>10 with BMI > 35 kg/m2 and NC>40 cm. Using an AHI ≥ 5 for OSA, 136 patients (90.6%) had OSA. Sensitivity of ESS > 10 for OSA was 55.15 % but increased to 72.79% when BMI > 35 kg/m2 and NC > 40 cm was added to patients with ESS > 10. Similarly specificity and predictive values of study population for diagnosing OSA also increased after adding BMI and NC to ESS. Conclusions: In this study adding body mass index (BMI) and NC to ESS score significantly increased the sensitivity and specificity and positive predictive value for diagnosis of OSA.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com