A Meta-analysis of Clinical Screening Tests for Obstructive Sleep Apnea
Open accessAbstract
The purpose of this meta-analysis is to compare clinical screening tests for obstructive sleep apnea and establish an evidence base for their preoperative use. Diagnostic odds ratios were used as summary measures of accuracy, and false-negative rates were used as measures of missed diagnosis with each screening test in this review. Metaregression revealed that clinical models, logarithmic equations, combined techniques, cephalometry, and morphometry are significant characteristics, whereas body mass index, history of hypertension, and nocturnal choking are significant test elements associated with higher diagnostic accuracy. Test accuracy in repeated validation studies of the same screening test is variable, suggesting an underlying heterogeneity in either the clinical presentation of obstructive sleep apnea or the measured clinical elements of these models. Based on the false-negative rates, it is likely that most of the clinical screening tests will miss a significant proportion of patients with obstructive sleep apnea.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Cephalometry alone may miss a significant proportion of patients with OSA in low-risk populations.
“Analysis of preoperative clinical screening tests for OSA revealed that cephalometry alone may miss a significant proportion of patients with OSA in low-risk populations.561”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [561]
The Discussion (p. 6) says false-negative rates mean most clinical prediction models may miss a significant proportion of patients with OSA. Study Limitations (p. 11) warns that models tested in high-risk patients can have lower sensitivity in lower-risk populations. The paper does not establish that cephalometry alone has this false-negative rate; it describes a combined clinical-cephalometry model as among the most accurate. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139 · see citing works
The Occurrence of Sleep-Disordered Breathing among Middle-Aged Adults
Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S., & Badr, S. (1993) · New England Journal of Medicine · doi:10.1056/nejm199304293281704 · Cited by 10,183 · see citing works
Prospective Study of the Association between Sleep-Disordered Breathing and Hypertension
Peppard, P. E., Young, T., Palta, M., & Skatrud, J. (2000) · New England Journal of Medicine · doi:10.1056/nejm200005113421901 · Cited by 4,973 · see citing works
Using the Berlin Questionnaire To Identify Patients at Risk for the Sleep Apnea Syndrome
Netzer, N. C., Stoohs, R. A., Netzer, C. M., Clark, K., & Strohl, K. P. (1999) · Annals of Internal Medicine · doi:10.7326/0003-4819-131-7-199910050-00002 · Cited by 2,973 · see citing works
STOP Questionnaire: A Tool to Screen Patients for Obstructive Sleep Apnea
Chung, F., Yegneswaran, B., Liao, P., Chung, S. A., Vairavanathan, S., Islam, S., Khajehdehi, A., & Shapiro, C. M. (2008) · Anesthesiology · doi:10.1097/aln.0b013e31816d83e4 · Cited by 2,355 · see citing works
The diagnostic odds ratio: a single indicator of test performance
Glas, A. S., Lijmer, J. G., Prins, M. H., Bonsel, G. J., & Bossuyt, P. M. M. (2003) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(03)00177-x · Cited by 2,261 · see citing works
Young, T., Evans, L., Finn, L., & Palta, M. (1997) · Sleep · doi:10.1093/sleep/20.9.705 · Cited by 1,765 · see citing works
Systematic reviews of evaluations of diagnostic and screening tests
Deeks, J. J. (2001) · BMJ · doi:10.1136/bmj.323.7305.157 · Cited by 1,345 · see citing works
Practice Guidelines for the Perioperative Management of Patients with Obstructive Sleep Apnea
Gross, J. B., Bachenberg, K. L., Benumof, J. L., Caplan, R. A., Connis, R. T., Coté, C. J., Nickinovich, D. G., Prachand, V. N., Ward, D. S., Weaver, E. M., et al. (2006) · Anesthesiology · doi:10.1097/00000542-200605000-00026 · Cited by 1,182 · see citing works
Daytime Sleepiness, Snoring, and Obstructive Sleep Apnea
Johns, M. W. (1993) · CHEST Journal · doi:10.1378/chest.103.1.30 · Cited by 1,118 · see citing works
Day–Night Pattern of Sudden Death in Obstructive Sleep Apnea
Gami, A. S., Howard, D. E., Olson, E. J., & Somers, V. K. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa041832 · Cited by 1,032 · see citing works
Association of Sleep-disordered Breathing and the Occurrence of Stroke
Arzt, M. E., Young, T. B., Finn, L. A., Skatrud, J. B., & Bradley, T. D. (2005) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200505-702oc · Cited by 951 · see citing works
Sources of Variation and Bias in Studies of Diagnostic Accuracy
Whiting, P. F., Rutjes, A. W., Reitsma, J. B., Glas, A. S., Bossuyt, P. M., & Kleijnen, J. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-140-3-200402030-00010 · Cited by 801 · see citing works
Guidelines for Meta-analyses Evaluating Diagnostic Tests
Irwig, L., Tosteson, A. N. A., Gatsonis, C., Lau, J., Colditz, G. A., Chalmers, T. C., & Mosteller, F. (1994) · Annals of Internal Medicine · doi:10.7326/0003-4819-120-8-199404150-00008 · Cited by 754 · see citing works
Access to Diagnosis and Treatment of Patients with Suspected Sleep Apnea
Flemons, W. W., Douglas, N. J., Kuna, S. T., Rodenstein, D. O., & Wheatley, J. R. (2004) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200308-1124pp · Cited by 671 · see citing works
Gupta, R. M., Parvizi, J., Hanssen, A. D., & Gay, P. C. (2001) · Mayo Clinic Proceedings · doi:10.4065/76.9.897 · Cited by 622 · see citing works
Chung, F., Yegneswaran, B., Liao, P., Chung, S. A., Vairavanathan, S., Islam, S., Khajehdehi, A., & Shapiro, C. M. (2008) · Anesthesiology · doi:10.1097/aln.0b013e31816d91b5 · Cited by 571 · see citing works
The Sleep Disorders Questionnaire I: Creation and Multivariate Structure of SDQ
Douglass, A. B., Bomstein, R., Nino‐Murcia, G., Keenan, S. A., Miles, L. E. M., Zarcone, V. P., Guilleminault, C., & Dement, W. C. (1994) · SLEEP · doi:10.1093/sleep/17.2.160 · Cited by 560 · see citing works
An independent association between obstructive sleep apnoea and coronary artery disease
Peker, Y., Kraiczi, H., Hedner, J. A., Löth, S., Johansson, A., & Bende, M. (1999) · European Respiratory Journal · doi:10.1034/j.1399-3003.1999.14a30.x · Cited by 476 · see citing works
Exploring sources of heterogeneity in systematic reviews of diagnostic tests
Lijmer, J. G., Bossuyt, P. M., & Heisterkamp, S. H. (2002) · Statistics in Medicine · doi:10.1002/sim.1185 · Cited by 446 · see citing works
Estimating Diagnostic Accuracy from Multiple Conflicting Reports
Littenberg, B., & Moses, L. E. (1993) · Medical Decision Making · doi:10.1177/0272989x9301300408 · Cited by 425 · see citing works
A Predictive Morphometric Model for the Obstructive Sleep Apnea Syndrome
Kushida, C. A., Efron, B., & Guilleminault, C. (1997) · Annals of Internal Medicine · doi:10.7326/0003-4819-127-8_part_1-199710150-00001 · Cited by 341 · see citing works
Spectrum Bias or Spectrum Effect? Subgroup Variation in Diagnostic Test Evaluation
Engel, S. A. M., & Miller, W. C. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-137-7-200210010-00011 · Cited by 331 · see citing works
A Randomized Controlled Trial of Continuous Positive Airway Pressure in Mild Obstructive Sleep Apnea
Barnes, M., Houston, D., Worsnop, C. J., Neill, A. M., Mykytyn, I. J., Kay, A., Trinder, J., Saunders, N. A., McEvoy, R. D., & Pierce, R. J. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.165.6.2003166 · Cited by 329 · see citing works
Are History and Physical Examination a Good Screening Test for Sleep Apnea?
Viner, S., Szalai, J. P., & Hoffstein, V. (1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-115-5-356 · Cited by 294 · see citing works
Churches, T. (2003) · BMC Medical Research Methodology · doi:10.1186/1471-2288-3-1 · Cited by 241 · see citing works
The Use of Clinical Prediction Formulas in the Evaluation of Obstructive Sleep Apnea
Rowley, J. A., Aboussouan, L. S., & Badr, M. S. (2000) · SLEEP · doi:10.1093/sleep/23.7.929 · Cited by 224 · see citing works
Obstructive Sleep Apnea as a Risk Marker in Coronary Artery Disease
Schäfer, H., Koehler, U., Ewig, S., Hasper, E., Tasci, S., & Lüderitz, B. (1999) · Cardiology · doi:10.1159/000006952 · Cited by 219 · see citing works
Sequential boundaries approach in clinical trials with unequal allocation ratios
Jafari, P., Ayatollahi, S. M. T., & Behboodian, J. (2006) · BMC Medical Research Methodology · doi:10.1186/1471-2288-6-1 · Cited by 217 · see citing works
Predicting Sleep Apnea and Excessive Day Sleepiness in the Severely Obese
Dixon, J. B., Schachter, L. M., & O’Brien, P. E. (2003) · CHEST Journal · doi:10.1378/chest.123.4.1134 · Cited by 212 · see citing works
Ahmadi, N., Chung, S. A., Gibbs, A. L., & Shapiro, C. M. (2007) · Sleep And Breathing · doi:10.1007/s11325-007-0125-y · Cited by 188 · see citing works
Sharma, S. K., Vasudev, C., Sinha, S., Banga, A., Pandey, R. M., & Handa, K. K. (2006) · PubMed · Cited by 185 · see citing works
Pulmonary Hypertension, Hypoxemia, and Hypercapnia in Obstructive Sleep Apnea Patients
Krieger, J., Sforza, E. A., Apprill, M., Lantpert, E., Weitzenblum, E., & Ratomaharv, J. (1989) · CHEST Journal · doi:10.1378/chest.96.4.729 · Cited by 183 · see citing works
A cephalometric comparison of subjects with snoring and obstructive sleep apnoea
Battagel, J. M. (2000) · European Journal of Orthodontics · doi:10.1093/ejo/22.4.353 · Cited by 178 · see citing works
Night-to-Night Variability in Sleep Apnea and Sleep-Related Periodic Leg Movements in the Elderly
Mosko, S. S., Dickel, M. J., & Ashurst, J. T. (1988) · SLEEP · doi:10.1093/sleep/11.4.340 · Cited by 175 · see citing works
The cephalometric morphology of patients with obstructive sleep apnoea (OSA)
Battagel, J. M., & L'Estrange, P. R. (1996) · European Journal of Orthodontics · doi:10.1093/ejo/18.6.557 · Cited by 159 · see citing works
Screening for Sleep Apnea Using Pulse Oximetry and A Clinical Score
Williams, A. J., Yu, G. W., Santiago, S., & Stein, M. (1991) · CHEST Journal · doi:10.1378/chest.100.3.631 · Cited by 155 · see citing works
Relative Validity of Self-Reported Snoring as a Symptom of Sleep Apnea in a Sleep Clinic Population
Bliwise, D. L., Nekich, J. C., & Dement, W. C. (1991) · CHEST Journal · doi:10.1378/chest.99.3.600 · Cited by 139 · see citing works
Chervin, R. D., Murman, D. L., Malow, B. A., & Totten, V. (1999) · Annals of Internal Medicine · doi:10.7326/0003-4819-130-6-199903160-00006 · Cited by 138 · see citing works
Occupational Screening for Obstructive Sleep Apnea in Commercial Drivers
Gurubhagavatula, I., Maislin, G., Nkwuo, J. E., & Pack, A. I. (2004) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200307-968oc · Cited by 134 · see citing works
Weatherwax, K. J., Lin, X., Marzec, M. L., & Malow, B. A. (2003) · Sleep Medicine · doi:10.1016/j.sleep.2003.07.004 · Cited by 107 · see citing works
Neural Network Prediction of Obstructive Sleep Apnea From Clinical Criteria
Kirby, S. D., Danter, W. R., George, C. F., Francovic, T., Ferguson, K. A., Eng, P., & Ruby, R. R. F. (1999) · CHEST Journal · doi:10.1378/chest.116.2.409 · Cited by 101 · see citing works
An Algorithm to Stratify Sleep Apnea Risk in a Sleep Disorders Clinic Population
Gurubhagavatula, I., Maislin, G., & Pack, A. I. (2001) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.164.10.2103039 · Cited by 84 · see citing works
Factors Related to Sleep Apnea Syndrome in Sleep Clinic Patients
Dealberto, M.-J., Ferber-Viart, C., Garma, L., Lemoine, P., & Alpérovitch, A. (1994) · CHEST Journal · doi:10.1378/chest.105.6.1753 · Cited by 79 · see citing works
The Epworth Sleepiness Scale: can it be used for sleep apnoea screening among snorers?
Osman, E. Z., Osborne, J., Hill, P. D., & Lee, B.-J. (1999) · Clinical Otolaryngology · doi:10.1046/j.1365-2273.1999.00256.x · Cited by 68 · see citing works
Model for investigating snorers with suspected sleep apnoea.
Rauscher, H., Popp, W., & Zwick, H. (1993) · Thorax · doi:10.1136/thx.48.3.275 · Cited by 63 · see citing works
Haraldsson, P.-O., Carenfelt, C., KNUTSSON, E., Persson, H., & Rinder, J. (1992) · SLEEP · doi:10.1093/sleep/15.3.261 · Cited by 61 · see citing works
A Clinical Decision Rule to Prioritize Polysomnography in Patients with Suspected Sleep Apnea
Rodsutti, J., Hensley, M., Thakkinstian, A., D’Este, C. A., & Attia, J. (2004) · SLEEP · doi:10.1093/sleep/27.4.694 · Cited by 55 · see citing works
Schäfer, H., Ewig, S., Hasper, E., & Lüderitz, B. (2009) · Respiration · doi:10.1159/000196670 · Cited by 47 · see citing works
Is venous thromboembolism more frequent in patients with obstructive sleep apnea syndrome?
Ambrosetti, M., Lucioni, A. M., Ageno, W., Conti, S., & Neri, M. (2004) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2004.00913.x · Cited by 38 · see citing works
Portable Monitoring in the Diagnosis of the Obstructive Sleep Apnea Syndrome
Littner, M. R. (2005) · Seminars in Respiratory and Critical Care Medicine · doi:10.1055/s-2005-864200 · Cited by 37 · see citing works
Jung, D. G., Cho, H. Y., Grunstein, R. R., & Yee, B. J. (2004) · Journal of Korean Medical Science · doi:10.3346/jkms.2004.19.5.662 · Cited by 37 · see citing works
Pillar, G., Peled, N., Katz, N., & Lavie, P. (1994) · Journal of Sleep Research · doi:10.1111/j.1365-2869.1994.tb00137.x · Cited by 31 · see citing works
Screening for Obstructive Sleep Apnea in Patients Presenting for Snoring Surgery
Pradhan, P. S., Gliklich, R. E., & Winkelman, J. W. (1996) · The Laryngoscope · doi:10.1097/00005537-199611000-00016 · Cited by 31 · see citing works
Identifying Obstructive Sleep Apnea in Patients Presenting for Laser‐Assisted Uvulopalatoplasty
Vaidya, A. M., Petruzzelli, G. J., Walker, R. P., McGee, D., & Gopalsami, C. (1996) · The Laryngoscope · doi:10.1097/00005537-199604000-00008 · Cited by 19 · see citing works
Blackman, N. J. (2001) · PubMed · Cited by 14 · see citing works
Uptake of antenatal screening for HIV infection can be high outside London too
Dean, G. L., Fisher, M., & Ottewill, M. (2001) · BMJ · doi:10.1136/bmj.323.7322.1188b · Cited by 6 · see citing works
Flagged first, then by citations
Research works printed but not linked: 7
- [2]2. Kaw RR, Golish JJ, Ghamande SS, Burgess RR, Foldvary NN, Walker EE: Incremental risk of obstructive sleep apnea on cardiac surgical outcomes. J Cardiovasc Surg (Torino) 2006; 47:683-9
- [7]7. Arzt M, Young T, Finn L, Skatrud JB, Bradley TD: Association of sleepdisordered breathing and the occurrence of stroke. Am J Respir Crit Care Med 2005; 172:1447-51
- [17]17. Ross SD, Sheinhait IA, Harrison KJ, Kvasz M, Connelly JE, Shea SA, Allen IE: Systematic review and meta-analysis of the literature regarding the diagnosis of sleep apnea. Sleep 2000; 23:519-32
- [19]19. Whiting P, Rutjes A, Reitsma J, Bossuyt P, Kleijnen J: The development of QUADAS: A tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol 2003; 3:1-13
- [21]21. Blackman NJ-M, ter Riet G, Kessels AGH, Bachmann LM: Systematic reviews of evaluations of diagnostic and screening tests (letter). BMJ 2001; 323: 1188
- [22]22. Zamora J, Abraira V, Muriel A, Khan K, Coomarasamy A: Meta-DiSc: A software for meta-analysis of test accuracy data. BMC Med Res Methodol 2006; 6:1-12
- [34]34. Wittig RM, Romaker A, Zorick FJ, Roehrs TA, Conway WA, Roth T: Night-to-night consistency of apneas during sleep. Am Rev Respir Dis 1984; 129:244-6
Cited by
Sorted by citations
Meschia, J. F., Bushnell, C., Boden-Albala, B., Braun, L. T., Bravata, D. M., Chaturvedi, S., Creager, M. A., Eckel, R. H., Elkind, M. S. V., Fornage, M., et al. (2014) · Stroke · doi:10.1161/str.0000000000000046 · Cited by 2,650 · see citing works
Chung, F., Abdullah, H. R., & Liao, P. (2016) · Chest · doi:10.1378/chest.15-0903 · Cited by 1,362 · see citing works
High STOP-Bang score indicates a high probability of obstructive sleep apnoea
Chung, F., Subramanyam, R., Liao, P., Sasaki, E., Shapiro, C., & Sun, Y. (2012) · British Journal of Anaesthesia · doi:10.1093/bja/aes022 · Cited by 988 · see citing works
Nagappa, M., Liao, P., Wong, J., Auckley, D., Ramachandran, S. K., Memtsoudis, S., Mokhlesi, B., & Chung, F. (2015) · PLOS ONE · doi:10.1371/journal.pone.0143697 · Cited by 684 · see citing works
Self-citationChiu, H.-Y., Chen, P.-Y., Chuang, L.-P., Chen, N.-H., Tu, Y.-K., Hsieh, Y.-J., Wang, Y.-C., & Guilleminault, C. (2017) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2016.10.004 · Cited by 650 · see citing works
A systematic review of screening questionnaires for obstructive sleep apnea
Abrishami, A., Khajehdehi, A., & Chung, F. (2010) · Canadian Journal of Anesthesia/Journal canadien d'anesthésie · doi:10.1007/s12630-010-9280-x · Cited by 581 · see citing works
Chung, F., Memtsoudis, S. G., Ramachandran, S. K., Nagappa, M., Opperer, M., Cozowicz, C., Patrawala, S., Lam, D., Kumar, A., Joshi, G. P., et al. (2016) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000001416 · Cited by 360 · see citing works
“143,144 Specific screening tools are associated with significantly greater accuracy than others, but there is a large heterogeneity within each individual screening test.”
BackgroundInfluentialSelf-citationInternational Consensus Statement on Obstructive Sleep Apnea
Chang, J. L., Goldberg, A. N., Alt, J. A., Mohammed, A., Ashbrook, L., Auckley, D., Ayappa, I., Bakhtiar, H., Barrera, J. E., Bartley, B. L., et al. (2023) · International Forum of Allergy & Rhinology · doi:10.1002/alr.23079 · Cited by 350 · see citing works
Silva, G. E., Vana, K. D., Goodwin, J. L., Sherrill, D. L., & Quan, S. F. (2011) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.1308 · Cited by 291 · see citing works
Joshi, G. P., Ankichetty, S. P., Gan, T. J., & Chung, F. F. (2012) · Anesthesia & Analgesia · doi:10.1213/ane.0b013e318269cfd7 · Cited by 288 · see citing works
Chung, F. F., Yang, Y., Brown, R., & Liao, P. (2014) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.4022 · Cited by 249 · see citing works
Farney, R. J., Walker, B. S., Farney, R. M., Snow, G. L., & Walker, J. M. (2011) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.1306 · Cited by 246 · see citing works
Sleep-Disordered Breathing and Postoperative Outcomes After Elective Surgery
Mokhlesi, B., Hovda, M. D., Vekhter, B., Arora, V. M., Chung, F., & Meltzer, D. O. (2013) · Chest · doi:10.1378/chest.12-2905 · Cited by 194 · see citing works
Reduced sleep as an obesity risk factor
Patel, S. R. (2009) · Obesity Reviews · doi:10.1111/j.1467-789x.2009.00664.x · Cited by 164 · see citing works
Screening Questionnaires for Obstructive Sleep Apnea: An Updated Systematic Review
Amra, B., Rahmati, B., Soltaninejad, F., & Feizi, A. (2018) · Oman Medical Journal · doi:10.5001/omj.2018.36 · Cited by 142 · see citing works
Huynh, N. T., Morton, P. D., Rompre, P. H., Papadakis, A., & Remise, C. (2011) · American Journal of Orthodontics and Dentofacial Orthopedics · doi:10.1016/j.ajodo.2011.03.023 · Cited by 132 · see citing works
Seet, E. C. P., & Chung, F. F. (2010) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-010-9344-y · Cited by 132 · see citing works
Risk Assessment of Obstructive Sleep Apnea in a Population of Patients Undergoing Ambulatory Surgery
Stierer, T. L., Wright, C., George, A., Thompson, R. E., Wu, C. L., & Collop, N. A. (2010) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.27936 · Cited by 132 · see citing works
Serum Bicarbonate Level Improves Specificity of STOP-Bang Screening for Obstructive Sleep Apnea
Chung, F. F., Chau, E. H., Yang, Y., Liao, P., Hall, R., & Mokhlesi, B. (2012) · CHEST Journal · doi:10.1378/chest.12-1132 · Cited by 125 · see citing works
Evaluation of five different questionnaires for assessing sleep apnea syndrome in a sleep clinic
Pataka, A., Daskalopoulou, E., Kalamaras, G., Passa, K. F., & Argyropoulou, P. (2014) · Sleep Medicine · doi:10.1016/j.sleep.2014.03.012 · Cited by 125 · see citing works
Derivation and Validation of a Simple Perioperative Sleep Apnea Prediction Score
Ramachandran, S. K., Kheterpal, S., Consens, F., Shanks, A., Doherty, T. M., Morris, M., & Tremper, K. K. (2010) · Anesthesia & Analgesia · doi:10.1213/ane.0b013e3181d489b0 · Cited by 117 · see citing works
Self-citationThe Value of Oxygen Desaturation Index for Diagnosing Obstructive Sleep Apnea: A Systematic Review
Rashid, N. H., Zaghi, S., Scapuccin, M., Camacho, M., Certal, V., & Capasso, R. (2021) · The Laryngoscope · doi:10.1002/lary.28663 · Cited by 115 · see citing works
Jinmei, L., Rong, H., Xu, Z., Yi, X., & Jiong, Z. (2014) · Chinese Medical Journal · doi:10.3760/cma.j.issn.0366-6999.20141196 · Cited by 104 · see citing works
“Most screening tools for OSAHS have been validated.(10) Most of them need calculation and computer assistance and are not applied properly in clinical work.”
MethodInfluentialNishiyama, T., Mizuno, T., Kojima, M., Suzuki, S., Kitajima, T., Ando, K. B., Kuriyama, S., & Nakayama, M. (2014) · Sleep Medicine · doi:10.1016/j.sleep.2013.12.015 · Cited by 91 · see citing works
European Respiratory Society statement on sleep apnoea, sleepiness and driving risk
Bonsignore, M. R., Randerath, W., Schiza, S., Verbraecken, J., Elliott, M. W., Riha, R., Barbe, F., Bouloukaki, I., Castrogiovanni, A., Deleanu, O., et al. (2021) · European Respiratory Journal · doi:10.1183/13993003.01272-2020 · Cited by 84 · see citing works
Vaz, A. P., Drummond, M., Mota, P. C., Severo, M., Almeida, J., & Winck, J. C. (2011) · Revista Portuguesa de Pneumologia · doi:10.1016/s2173-5115(11)70015-x · Cited by 84 · see citing works
Coté, G. A., Hovis, C. E., Hovis, R. M., Waldbaum, L., Early, D. S., Edmundowicz, S. A., Azar, R. R., Mullady, D. K., & Jonnalagadda, S. S. (2010) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2010.05.015 · Cited by 81 · see citing works
Screening and assessment for obstructive sleep apnea in primary care
Miller, J. N., & Berger, A. M. (2015) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2015.09.005 · Cited by 81 · see citing works
Guidelines for sleep studies in adults-a position statement of the Australasian Sleep Association
Douglas, J. A., Chai-Coetzer, C. L., McEvoy, D., Naughton, M. T., Neill, A. M., Rochford, P., Wheatley, J., & Worsnop, C. (2017) · Sleep Medicine · doi:10.1016/j.sleep.2017.03.019 · Cited by 78 · see citing works
Bernhardt, L., Brady, E. M., Freeman, S. C., Polmann, H., Réus, J. C., Flores‐Mir, C., Canto, G. D. L., Robertson, N., & Squire, I. B. (2021) · Sleep And Breathing · doi:10.1007/s11325-021-02450-9 · Cited by 78 · see citing works
Tantrakul, V., Numthavaj, P., Guilleminault, C., McEvoy, M., Panburana, P., Khaing, W., Attia, J., & Thakkinstian, A. (2016) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2016.11.003 · Cited by 78 · see citing works
Vaz, A. P., Drummond, M., Mota, P. C., Severo, M., Almeida, J., & Winck, J. C. (2011) · Revista Portuguesa de Pneumologia · doi:10.1016/s0873-2159(11)70015-0 · Cited by 73 · see citing works
Ling, I., James, A. L., & Hillman, D. R. (2011) · SLEEP · doi:10.5665/sleep.1592 · Cited by 73 · see citing works
Obstructive Sleep Apnea: Preoperative Assessment
Seet, E. C. P., & Chung, F. F. (2010) · Anesthesiology Clinics · doi:10.1016/j.anclin.2010.02.002 · Cited by 71 · see citing works
Vinson, D. C., Manning, B. K., Galliher, J. M., Dickinson, L. M., Pace, W. D., & Turner, B. J. (2010) · The Annals of Family Medicine · doi:10.1370/afm.1175 · Cited by 67 · see citing works
Acelajado, M. C., & Calhoun, D. A. (2010) · Cardiology Clinics · doi:10.1016/j.ccl.2010.07.002 · Cited by 69 · see citing works
Duarte, R., Fonseca, L. B. D. M., Magalhães-da-Silveira, F. J., Silveira, É. A., & Rabahi, M. F. (2017) · Jornal Brasileiro de Pneumologia · doi:10.1590/s1806-37562017000000139 · Cited by 64 · see citing works
Duarte, R. L. M., Rabahi, M. F., Magalhães-da-Silveira, F. J., Sá, T., Mello, F. C. D. Q., & Gozal, D. (2018) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7202 · Cited by 64 · see citing works
Abma, I. L., van der Wees, P. J., Veer, V., Westert, G. P., & Rovers, M. M. (2015) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2015.07.006 · Cited by 64 · see citing works
Translation and validation of Berlin questionnaire in primary health care in Greece
Bouloukaki, I., Komninos, I. D., Mermigkis, C. M., Micheli, K., Komninou, M., Moniaki, V., Mauroudi, E., Siafakas, N. M., & Schiza, S. E. (2013) · BMC Pulmonary Medicine · doi:10.1186/1471-2466-13-6 · Cited by 61 · see citing works
Fernandez-Bustamante, A., Bartels, K., Clavijo, C., Scott, B. K., Kacmar, R., Bullard, K., Moss, A. F. D., Henderson, W., Juarez-Colunga, E., & Jameson, L. (2017) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000002241 · Cited by 59 · see citing works
Meta-analysis of the association between obstructive sleep apnea and postoperative complications
Sun, X., Yu, J., Luo, J., Xu, S., Yang, N., & Wang, Y. (2022) · Sleep Medicine · doi:10.1016/j.sleep.2021.11.019 · Cited by 58 · see citing works
Aguiar, I. D. C., de Freitas, W. R., Santos, I. R., Apostólico, N., Nacif, S. R., Urbano, J. J., Fonsêca, N. T., Thuler, F., Ilias, E. J., Kassab, P., et al. (2014) · Multidisciplinary Respiratory Medicine · doi:10.1186/2049-6958-9-43 · Cited by 58 · see citing works
Cordovani, L., Chung, F. F., Germain, G., Turner, K. E., Turgeon, A. F., Hall, R., Gay, P. C., Bryson, G. L., & Choi, P. T. (2015) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-015-0512-y · Cited by 54 · see citing works
The high prevalence of obstructive sleep apnea among patients with bipolar disorders
Kelly, T., Douglas, L., Denmark, L., Brasuell, G., & Lieberman, D. Z. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.05.047 · Cited by 51 · see citing works
Undiagnosed Obstructive Sleep Apnea and Postoperative Outcomes: A Prospective Observational Study
Devaraj, U., Rajagopala, S., Kumar, A. M. V., Ramachandran, P., Devereaux, P. J., & D′Souza, G. (2017) · Respiration · doi:10.1159/000470914 · Cited by 51 · see citing works
Pataka, A., Kotoulas, S., Kalamaras, G., Schiza, S., Sapalidis, K. G., Giannakidis, D., Michalopoulos, N., Koulouris, C., Aidoni, Z., Amaniti, A., et al. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9010130 · Cited by 51 · see citing works
Qaddoura, A., Kabali, C., Drew, D., van Oosten, E. M., Michael, K. A., Redfearn, D., Simpson, C. S., & Baranchuk, A. M. (2014) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2014.10.014 · Cited by 50 · see citing works
Ioachimescu, O. C., & Collop, N. A. (2012) · Neurologic Clinics · doi:10.1016/j.ncl.2012.08.003 · Cited by 50 · see citing works
Reis, R., Teixeira, F., Martins, V., Sousa, L., Batata, L., Santos, C., & Moutinho, J. (2015) · Revista Portuguesa de Pneumologia · doi:10.1016/j.rppnen.2014.04.009 · Cited by 50 · see citing works
Duarte, R. L. M., Magalhães-da-Silveira, F. J., Sá, T., Silva, J. A., de Mello, F. C. S., & Gozal, D. (2020) · Nature and Science of Sleep · doi:10.2147/nss.s238255 · Cited by 50 · see citing works
Resistant Hypertension and Obstructive Sleep Apnea in the Primary-Care Setting
Demede, M., Pandey, A. K., Zizi, F., Bachmann, R., Donat, M., McFarlane, S. I., Jean‐Louis, G., & Ogedegbe, G. G. (2011) · International Journal of Hypertension · doi:10.4061/2011/340929 · Cited by 49 · see citing works
Hong, C., Chen, R., Qing, S., Kuang, A., Yang, H., Su, X., Zhao, D., Wu, K., & Zhang, N. (2018) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.6930 · Cited by 48 · see citing works
Lai, J., Harrison, R. A., Plecash, A. R., & Field, T. S. (2018) · Headache The Journal of Head and Face Pain · doi:10.1111/head.13382 · Cited by 49 · see citing works
Benavides, A. M., Pozo, R. F., Toledano, D. T., Murillo, J. L. B., Gonzalo, E. L., & Gómez, L. A. H. (2013) · Computer Speech & Language · doi:10.1016/j.csl.2013.08.002 · Cited by 47 · see citing works
Considerations for patients with obstructive sleep apnea undergoing ambulatory surgery
Ankichetty, S. P., & Chung, F. F. (2011) · Current Opinion in Anaesthesiology · doi:10.1097/aco.0b013e32834a10c7 · Cited by 45 · see citing works
Computer-Assisted Diagnosis of the Sleep Apnea-Hypopnea Syndrome: A Review
Álvarez-Estévez, D., & Moret‐Bonillo, V. (2015) · Sleep Disorders · doi:10.1155/2015/237878 · Cited by 43 · see citing works
Sex-specific sleep apnea screening questionnaires: closing the performance gap in women
Bauters, F. A., Loof, S., Hertegonne, K. B. C., Chirinos, J. A., Buyzere, M. D., & Rietzschel, E. R. (2019) · Sleep Medicine · doi:10.1016/j.sleep.2019.10.023 · Cited by 44 · see citing works
BaHammam, A. S., Alaqeel, A., Alhedyani, A. A., Al-Obaid, G. I., Al-Owais, M. M., & Olaish, A. H. (2015) · The Open Respiratory Medicine Journal · doi:10.2174/1874306401509010022 · Cited by 42 · see citing works
Hein, M., Lanquart, J., Loas, G., Hubain, P., & Linkowski, P. (2017) · Respiratory Research · doi:10.1186/s12931-017-0616-8 · Cited by 41 · see citing works
Miller, J. N., Kupzyk, K. A., Zimmerman, L. M., Pozehl, B., Schulz, P., Romberger, D. J., & Berger, A. M. (2018) · Sleep Medicine · doi:10.1016/j.sleep.2018.06.007 · Cited by 42 · see citing works
Obesity, Hypersomnolence, and Quality of Sleep: the Impact of Bariatric Surgery
Pinto, T. F., de Bruin, P. F. C., de Bruin, V. M. S., Lopes, P. M., & Lemos, F. N. (2017) · Obesity Surgery · doi:10.1007/s11695-016-2536-y · Cited by 41 · see citing works
Magalhães, E., Marques, F. O., Govêia, C. S., Ladeira, L. C. A., & Lagares, J. (2013) · Brazilian Journal of Anesthesiology · doi:10.1016/s0034-7094(13)70228-9 · Cited by 39 · see citing works
Hein, M., Lanquart, J., Loas, G., Hubain, P., & Linkowski, P. (2017) · BMC Pulmonary Medicine · doi:10.1186/s12890-017-0522-3 · Cited by 38 · see citing works
Mou, J., Pflugeisen, B. M., Crick, B. A., Amoroso, P. J., Harmon, K. T., Tarnoczy, S. F., Ho, S. S., & Mebust, K. A. (2018) · Sleep And Breathing · doi:10.1007/s11325-018-1658-y · Cited by 38 · see citing works
Luo, J., Huang, R., Zhong, X., Xiao, Y., & Zhou, J. (2014) · Chinese Medical Journal · doi:10.3760/cma.j.issn.0366-6999.20133003 · Cited by 37 · see citing works
Deflandre, E., Degey, S., Brichant, J.-F., Poirrier, R., & Bonhomme, V. (2016) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000001089 · Cited by 36 · see citing works
Excessive Daytime Sleepiness Among Japanese Public Transportation Drivers Engaged in Shiftwork
Asaoka, S., Namba, K., Tsuiki, S., Komada, Y., & Inoue, Y. (2010) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0b013e3181ea5a67 · Cited by 36 · see citing works
Obstructive sleep apnea and severity of coronary artery disease.
Vasheghani‐Farahani, A., Kazemnejad, F., Sadeghniiat‐Haghighi, K., Saadat, S., Tavakolipoor, P., Yazdani, T., Alidoosti, M., Amooeian, V. G., & Ashraf, H. (2018) · Europe PMC (PubMed Central) · doi:10.22088/cjim.9.3.276 · Cited by 42 · see citing works
Mehta, V., Subramanyam, R., Shapiro, C. M., & Chung, F. F. (2012) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-012-9694-8 · Cited by 35 · see citing works
Jeon, H. J., Bang, Y. R., & Yoon, I. (2018) · Sleep And Breathing · doi:10.1007/s11325-018-1748-x · Cited by 34 · see citing works
Pre-operative screening for obstructive sleep apnoea
Verbraecken, J. A., Hedner, J. A., & Penzel, T. (2017) · European Respiratory Review · doi:10.1183/16000617.0012-2016 · Cited by 34 · see citing works
Singh, M., Tuteja, A., Wong, D. T., Goel, A., Trivedi, A., Tomlinson, G., & Chan, V. (2019) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000004350 · Cited by 33 · see citing works
Application value of the NoSAS score for screening sleep-disordered breathing
Peng, M., Chen, R., Cheng, J., Li, J., Liu, W., & Hong, C. (2018) · Journal of Thoracic Disease · doi:10.21037/jtd.2018.07.46 · Cited by 33 · see citing works
Ruel, G., Martin, S. A., Lévesque, J., Wittert, G., Adams, R., Appleton, S., Shi, Z., & Taylor, A. W. (2018) · Global Health · doi:10.1017/gheg.2018.9 · Cited by 32 · see citing works
Prediction in obstructive sleep apnoea: diagnosis, comorbidity risk, and treatment outcomes
Sutherland, K., Almeida, F. R., de Chazal, P., & Cistulli, P. A. (2018) · Expert Review of Respiratory Medicine · doi:10.1080/17476348.2018.1439743 · Cited by 33 · see citing works
Validation of the oxygen desaturation index in the diagnostic workup of obstructive sleep apnea
Fabius, T. M., Benistant, J. R., Bekkedam, L., van der Palen, J. A. M., de Jongh, F. H., & Eijsvogel, M. (2018) · Sleep And Breathing · doi:10.1007/s11325-018-1654-2 · Cited by 32 · see citing works
Exploring the STOP-BANG questionnaire for obstructive sleep apnea screening in seniors
Martins, E. F., Martinez, D., Cortes, A., Nascimento, N., & Brendler, J. H. (2020) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.8166 · Cited by 32 · see citing works
Avaliação de um modelo de predição para apneia do sono em pacientes submetidos a polissonografia
Musman, S., Passos, V. M. D. A., Silva, I. B. R., & Barreto, S. M. (2011) · Jornal Brasileiro de Pneumologia · doi:10.1590/s1806-37132011000100012 · Cited by 32 · see citing works
Liou, S.-C., Hsu, C., Chen, C., Su, M., & Chiu, C. (2018) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s170498 · Cited by 31 · see citing works
Lecube, A., Sánchez, E., Peralta, F. G., Abreu, C., Valls, J., Mestre, O., Romero, O., de la Calzada, M. D., Sampol, G., Ciudin, A., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0157579 · Cited by 30 · see citing works
Anaesthetic management of sleep‐disordered breathing in adults
Hillman, D. R., & Chung, F. F. (2016) · Respirology · doi:10.1111/resp.12967 · Cited by 30 · see citing works
Graco, M., Schembri, R., Cross, S., Thiyagarajan, C., Shafazand, S., Ayas, N., Nash, M. S., Vu, V. H., Ruehland, W. R., Chai‐Coetzer, C. L., et al. (2018) · Thorax · doi:10.1136/thoraxjnl-2017-211131 · Cited by 30 · see citing works
Mungan, U., Özeke, Ö., Mavioğlu, L., Ertan, Ç., Karaca, I. O., Keskin, G., Kokcu, Z., Selimoglu, Y., Demir, A. D., & Özatık, M. A. (2012) · Heart Lung and Circulation · doi:10.1016/j.hlc.2012.08.003 · Cited by 28 · see citing works
Orlov, D., Ankichetty, S. P., Chung, F. F., & Brull, R. (2013) · Journal of Clinical Anesthesia · doi:10.1016/j.jclinane.2013.02.015 · Cited by 29 · see citing works
A screening tool for obstructive sleep apnea in cerebrovascular patients
Katzan, I. L., Thompson, N. R., Uchino, K., & Foldvary‐Schaefer, N. (2016) · Sleep Medicine · doi:10.1016/j.sleep.2016.02.001 · Cited by 29 · see citing works
Screening commercial drivers for obstructive sleep apnea: Validation of STOP-Bang questionnaire
Popević, M. B., Milovanović, A., Nagorni-Obradović, L. M., Nešić, D., Milovanovic, J. P., & Milovanović, A. (2017) · International Journal of Occupational Medicine and Environmental Health · doi:10.13075/ijomeh.1896.00906 · Cited by 29 · see citing works
Screening for obstructive sleep apnoea in obesity and diabetes – potential for future approaches
Seetho, I. W., & Wilding, J. P. H. (2013) · European Journal of Clinical Investigation · doi:10.1111/eci.12083 · Cited by 28 · see citing works
Utility of the STOP-BANG components to identify sleep apnea using home respiratory polygraphy
Borsini, E. E., Ernst, G., Salvado, A., Bosio, M., Chertcoff, J., Nogueira, F., & Nigro, C. A. (2015) · Sleep And Breathing · doi:10.1007/s11325-015-1174-2 · Cited by 26 · see citing works
Xiong, M., Hu, W., Dong, M., Wang, M., Chen, J., Xiong, H., Zhong, M., Jiang, Y., Liu, D., & Hu, K. (2019) · International Journal of COPD · doi:10.2147/copd.s223354 · Cited by 25 · see citing works
Tolleson, C., Bagai, K., Walters, A. S., & Davis, T. L. (2016) · Neuromodulation Technology at the Neural Interface · doi:10.1111/ner.12442 · Cited by 26 · see citing works
Chung, F. F., Hillman, D. R., & Lydic, R. (2011) · Anesthesiology · doi:10.1097/aln.0b013e318216e858 · Cited by 25 · see citing works
Obstructive Sleep Apnea in Neuro-Ophthalmology
Wong, B., & Fraser, C. L. (2018) · Journal of Neuro-Ophthalmology · doi:10.1097/wno.0000000000000728 · Cited by 26 · see citing works
Ramachandran, S. K., Pandit, J. J., Devine, S., Leis, A. M., & Shanks, A. M. (2017) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000002132 · Cited by 24 · see citing works
Self-citationBrazilian Thoracic Association Consensus on Sleep-disordered Breathing
Duarte, R., Togeiro, S. M., Palombini, L., Rizzatti, F. P. G., Fagondes, S. C., Magalhães-da-Silveira, F. J., Cabral, M. M., Genta, P. R., Lorenzi‐Filho, G., Clímaco, D. C. S., et al. (2022) · Jornal Brasileiro de Pneumologia · doi:10.36416/1806-3756/e20220106 · Cited by 33 · see citing works
Sharara, A. I., Zahabi, L. E., Maasri, K., Hashash, J. G., Mansour, N., Skoury, A. M., Kanafani, Z. A., Bou–Khalil, P., & Husari, A. W. (2010) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2009.11.049 · Cited by 24 · see citing works
Ahlin, S., Manco, M., Panunzi, S., Verrastro, O., Giannetti, G., Prete, A. A., Guidone, C., Berardino, A. D. M., Viglietta, L., Ferravante, A. F., et al. (2019) · Medicine · doi:10.1097/md.0000000000016687 · Cited by 23 · see citing works
Popević, M. B., Milovanović, A., Nagorni-Obradović, L. M., Nešić, D., Milovanovic, J. P., & Milovanović, A. P. S. (2015) · Quality of Life Research · doi:10.1007/s11136-015-1087-3 · Cited by 23 · see citing works
Sankar, A., Dixon, P. R., Sivanathan, L., Memtsoudis, S. G., de Almeida, J. R., & Singh, M. (2020) · Anesthesiology · doi:10.1097/aln.0000000000003429 · Cited by 22 · see citing works
The Management of Surgical Patients with Obstructive Sleep Apnea
Porhomayon, J., El-Solh, A., Chhangani, S. V., & Nader, N. D. (2011) · Lung · doi:10.1007/s00408-011-9313-4 · Cited by 22 · see citing works
- Authors
- Ramachandran, S. K., & Josephs, L. A.
- Affiliations
- Michigan Medicine (US)
- Medical Student.
- Venue
- Anesthesiology
- Published
- 2009-04-01
- Volume
- 110
- Issue
- 4
- Pages
- 928-939
- ISSN
- 0003-3022 (ISSN-L)
- OpenAlex
- W2090495868
- Semantic Scholar
- 96975f4b61d63ccbe388c7ba3d8462ebdbdbfef0
- Cited by
- 297
- References
- 57
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 12 · 2023: 4 · 2022: 22 · 2021: 23 · 2020: 17 · 2019: 15 · 2018: 25 · 2017: 20 · 2016: 21 · 2015: 21 · 2014: 26 · 2013: 16 · 2012: 22
- FWCI
- 2.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Anesthesiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- obstructive sleep apnea, preoperative screening, diagnostic accuracy, false negative rate, cephalometric analysis, morphometrics, body mass index, hypertension, diagnostic odds ratio, meta-regression
- MeSH terms
- Clinical Protocols, Humans, Predictive Value of Tests, Surveys and Questionnaires, Risk Factors, Body Mass Index, Evidence-Based Medicine, Sleep Apnea, Obstructive
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
