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Diagnostic accuracy of the Berlin questionnaire and the NoSAS score in detecting risk for obstructive sleep apnea in rotating shift workers

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Background

Data on the validity of tools for sleep apnea risk detection in rotating shift workers are limited. The aim was to evaluate the Berlin questionnaire (BQ) and the Neck, Obesity, Snoring, Age, Sex (NoSAS) score for the detection of obstructive sleep apnea risk in shift workers.

Methods

This cross-sectional study included male rotating shift workers, drivers of heavy off-road machinery in an iron ore extraction company. Polysomnography was the gold standard for evaluation. Obstructive sleep apnea (OSA) was defined as an apnea–hypopnea index (AHI) of ≥ 5 events/h. The Shapiro–Wilk test verified the data distribution and comparative analysis was conducted using the chi-square analyses and U Mann–Whitney with Bonferroni correction. Receiver operating characteristic curve analysis, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and accuracy were used for evaluate BQ and NoSAS with OSA diagnosis by polysomnograph.

Results

Among 119 male shift workers, ages 24 to 57 years, polysomnography showed that 84% had obstructive sleep apnea (AHI ≥ 5), and 46% had moderate to severe sleep apnea (AHI ≥ 15). For AHI ≥ 5, the NoSAS score had higher sensitivity and specificity than the BQ. For AHI ≥ 15 and AHI ≥ 30, the NoSAS score had a sensitivity higher than 70% while BQ was 60% and 58%, respectively. The accuracy of the NoSAS score was higher for all OSA criteria than that of BQ.

Conclusion

In rotating shift workers, drivers of heavy off-road machinery, the NoSAS score showed higher accuracy in identifying patients at risk for sleep apnea than the BQ.

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Funding

This study was supported by the Conselho Brasileiro de Desenvolvimento Científico e Tecnológico (CNPq, Distrito Federal, Brazil) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brazil (CAPES), finance code 001 for PhD student scholarship.

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Authors and Affiliations

  1. Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil

    Luiz Antônio Alves de Menezes Júnior, George Luiz Lins Machado-Coelho & Adriana Lúcia Meireles

  2. Sciences Applied to Adult Health Care, Federal University of Minas Gerais, MG, 30130-100, Belo Horizonte, Brazil

    Virgínia Capistrano Fajardo

  3. School of Medicine, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil

    Raimundo Marques do Nascimento Neto, Fausto Aloísio Pedrosa Pimenta & George Luiz Lins Machado-Coelho

  4. School of Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil

    Sílvia Nascimento de Freitas & Adriana Lúcia Meireles

  5. Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil

    Fernando Luiz Pereira de Oliveira

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  1. Luiz Antônio Alves de Menezes Júnior
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Contributions

All authors made substantial contributions to the conception and design of the work, analysis, and interpretation of data and drafted the work and revised it critically for important intellectual content. All authors approved the version to be published.

Corresponding author

Correspondence to Luiz Antônio Alves de Menezes Júnior.

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Ethics approval

All procedures involving human subjects were approved by the Research Ethics Committee of the Federal University of Ouro Preto (CAAE: 39682014.7.0000.5150).

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This study was conducted according to the guidelines laid down in the Declaration of Helsinki and written informed consent was obtained from all subjects.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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de Menezes Júnior, L.A.A., Fajardo, V.C., do Nascimento Neto, R.M. et al. Diagnostic accuracy of the Berlin questionnaire and the NoSAS score in detecting risk for obstructive sleep apnea in rotating shift workers. Sleep Breath 26, 743–751 (2022). https://doi.org/10.1007/s11325-021-02446-5

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  • DOI: https://doi.org/10.1007/s11325-021-02446-5

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