New Tool for Detecting Severe Sleep Apnea Shows Promising Results

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The Obstructive Sleep Apnea Morphologic Scale (OSAMS), a new screening tool based on physical characteristics to assess the severity of obstructive sleep apnea (OSA), was shown to be more effective than existing questionnaires in identifying severe OSA cases.

The tool shows potential as a practical, morphology-based alternative for early screening, helping to prioritize patients who need further diagnostic testing and treatment. OSAMS could potentially alleviate the long wait times for polysomnography (PSG) and improve patient care by offering a faster, more accurate method of screening.

“The diagnosis of obstructive sleep apnea syndrome (OSAS) relies on the gold standard PSG,” wrote a team of investigators led by Utku Kubilay, MD, associated with the Department of ENT—Head and Neck, Tepecik Research and Training Hospital of the University of Health Sciences in Izmir, Turkey. “However, this diagnostic approach imposes significant patient burden and financial costs.”

Delays in diagnosis and treatment are common due to the small number of diagnostic centers, leading to extended waiting times for PSG. This is particularly concerning for patients with moderate to severe OSAS, as these delays could increase the risk of serious and potentially life-threatening complications.

Common symptoms of OSAS—a condition that is estimated to affect 6% to 17% of the general population—include excessive daytime sleepiness, snoring and apneic episodes that are witnessed by family members. It is a known risk factor for serious comorbidities including hypertension, stroke, coronary artery disease and diabetes mellitus. Individuals with upper airway obstructions, men, the elderly, people with obesity and smokers are more likely to develop OSAS.

In the current trial, investigators enrolled 149 adult patients with sleep apnea symptoms who did not have any diagnosed comorbidities. Researchers developed the tool using five parameters, both internal and external: tonsil size, oropharyngeal passage, hypopharyngeal-laryngeal examination, neck circumference and body mass index. The total scores of each parameter were compared with the apnea-hypopnea index (AHI) of PSG to assess a patient’s OSA severity.

The cohort was comprised of 122 men and 27 women with a mean age of 44.4 years among males and 51.1 years among females.

Ultimately, OSAMS worked better than existing questionnaires in detecting severe OSA. The tool demonstrated a statistically significant correlation with the standard AHI and showed a good balance of sensitivity (80.3%) and specificity (53.9%) in identifying patients who need further testing or treatment.

An important limitation of the study was the high rate of false positives when detecting severe OSAS, which investigators believe were due to subjectively evaluated internal morphological parameters, such as tongue position and tonsil size. They suggest using imagine techniques or digital measurements to increase reliability. Additionally, as the sample of patients were already suspected to have OSAS, there may have been a higher prevalence of positive results, which could potentially alter the specificity and sensitivity of the tool.

The team encourages future research to focus on recruiting more patients who are representative of the normal population—such as those with comorbidities—to continue to refine and validate OSAMS as a reliable screening option.

“Clinicians should recognize that OSAS is a multifaceted disorder influenced by various physiological factors, and its comprehensive understanding cannot be derived solely from a single physical examination finding,” investigators concluded. “The OSAMS system, which includes multiple morphological features, has been proven to be a valuable tool for screening patients with severe OSAS.”