The predictive values of BOAH and No-apnea score for screening obstructive sleep apnea in rotating shift worker drivers

Luiz Antônio Alves de Menezes-Júnior; Virgínia Capistrano Fajardo; Raimundo Marques do Nascimento Neto; Silvia Nascimento de Freitas; Fernando Luiz Pereira de Oliveira; Fausto Aloísio Pedrosa Pimenta; George Luiz Lins Machado-Coelho; Adriana Lúcia Meireles

doi:10.1016/j.sleepx.2023.100084

The predictive values of BOAH and No-apnea score for screening obstructive sleep apnea in rotating shift worker drivers

Sleep Med X. 2023 Sep 9:6:100084. doi: 10.1016/j.sleepx.2023.100084. eCollection 2023 Dec 15.

Authors

Luiz Antônio Alves de Menezes-Júnior¹, Virgínia Capistrano Fajardo², Raimundo Marques do Nascimento Neto³, Silvia Nascimento de Freitas⁴, Fernando Luiz Pereira de Oliveira⁵, Fausto Aloísio Pedrosa Pimenta³, George Luiz Lins Machado-Coelho^{1

3}, Adriana Lúcia Meireles^{1

4}

Affiliations

¹ Post-Graduate in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil.
² Post-Graduate in Applied Sciences in Adult Health, Federal University of Minas Gerais, Belo Horizonte, MG, 30130-100, Brazil.
³ School of Medicine, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil.
⁴ School of Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil.
⁵ Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil.

Abstract

Objective: To evaluate the BOAH (Body mass index, Observed apnea, Age, and Hypertension) and No-apnea score's diagnostic values for detecting obstructive sleep apnea (OSA) risk in shift workers.

Methods: Cross-sectional study with male rotating shift workers and drivers of heavy off-road machinery. The BOAH score is based on body mass index, witnessed apneas during sleep, age, and hypertension. The No-apnea score is based on neck circumference and age. Based on the apnea-hypopnea index (AHI), the severity of OSA was categorized as least mild OSA (AHI ≥5/h), moderate to severe OSA (AHI ≥15/h), and severe OSA (AHI ≥30/h). Sensitivity, specificity, positive predictive value, negative predictive value, and areas under the curve (AUC) were calculated.

Results: Among 119 workers evaluated, 84.0% had AHI ≥5, 46.2% had AHI ≥15, and 14.3% had AHI ≥30. BOAH score with 2 points for AHI ≥5, the AUC was 0.679, and sensitivity and specificity were 41.0% and 94.7%, respectively. No-apnea score with 3 points AHI ≥5, the AUC was 0.692, and sensitivity and specificity were 70.0% and 68.4%, respectively. Furthermore, using at least one of the positive scores, the AUC was higher when compared to the single tests for AHI ≥5 (AUC = 0.727). And when both scores were positive, the AUC was higher for AHI ≥30 (AUC = 0.706).

Conclusion: In rotating shift workers and drivers of heavy off-road machinery, BOAH, and No-apnea scores can be helpful tools in identifying individuals at risk for sleep apnea. In addition, matching the scores may increase the prediction of OSA.

Keywords: Driver; Obesity; Polysomnography; Sleep apnea syndromes; Workers.