调查问卷
调查问卷可用于检测OSAS,特别是在围手术期。[91]Chung F, Memtsoudis S, Krishna Ramachandran S, et al. Society of Anesthesia and Sleep Medicine guideline on preoperative screening and assessment of patients with obstructive sleep apnea. Anesth Analg. 2016 Jun 1 [Epub ahead of print].http://www.ncbi.nlm.nih.gov/pubmed/27258078?tool=bestpractice.com这样的问卷必须简单易于接受,但因此特异度受损。[92]Ramachandran SK, Josephs LA. A meta-analysis of clinical screening tests for obstructive sleep apnea. Anesthesiology. 2009;110:928-939.http://www.ncbi.nlm.nih.gov/pubmed/19293704?tool=bestpractice.comSTOP调查问卷包括有无响亮鼾声、呼吸暂停、白天过度嗜睡、高血压。对于严重的OSAS(AHI>30次/小时)的敏感度和特异度分别是80%和89%,但对于轻度OSA敏感度下降到65%。[93]Chung F, Yegneswaran B, Liao P, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008;108:812-821.http://www.ncbi.nlm.nih.gov/pubmed/18431116?tool=bestpractice.comSTOP-BANG问卷则把STOP问卷结合BMI、年龄和颈围、性别。对于重度OSAS敏感度达到100%,但特异度下降到37%。
高危人群
营运车司机、重装设备操作手、其他白天嗜睡的人应该筛查OSA既往史和体格检查,如果怀疑OSA,应行睡眠检查。不同的州或国家有不同的筛查规定。