CLINICAL-FEATURES AS DIAGNOSTIC GUIDES IN OBSTRUCTIVE SLEEP-APNEA

Obstructive sleep apnea (OSA) may induce psychiatric problems, but cli nical risk factors do not reliably predict laboratory-verified OSA. Th erefore, OSA diagnosis requires laboratory sleep monitoring. To find a dditional clinical features that would sharpen indications for sleep m onitoring, we applied univariate analyses to clinical data for 137 OSA patients seen in a psychiatry sleep clinic. A symptomatology question naire was obtained from 101 of these patients: 71 had morning and 86 h ad afternoon vigilance tests, and all had upper-airway evaluation and polysomnography. Cigarette consumption but no other clinical features differed among OSA severity groups and total sleep period groups; uppe r-airway findings differed among vigilance groups. Multidiscriminant c linical predictor terms categorized several patients with severe OSA i nto less severe OSA categories. Clinical features did not accurately p redict OSA. OSA will continue to be identified primarily by sleep labo ratory testing. A two-phase laboratory routine, reserving full laborat ory testing for patients with negative results on initial, less expens ive screening tests, might conserve resources. (C) 1995 by W.B. Saunde rs Company