Are history and physical examination a good screening test for sleep apnea?
Abstract: OBJECTIVE: To determine whether presenting clinical history, pharyngeal examination, and the overall subjective impression of the clinician could serve as a sensitive screening test for sleep apnea. DESIGN: Blinded comparison of history and physical examination with results of nocturnal polysomnography. SETTING: Sleep clinic of a tertiary referral center. PATIENTS: A total of 410 patients referred for suspected sleep apnea syndrome. Most patients reported snoring. MEASUREMENTS: All patients were asked standard questions and given an examination relevant to the diagnosis of the sleep apnea syndrome, and all had full nocturnal polysomnography. Patients with more than ten episodes of apnea or hypopnea per hour of sleep were classified as having sleep apnea. Stepwise linear logistic regression was used to develop two predictive models of sleep apnea: one based on the presence of characteristic clinical features, age, sex, and body mass index; and one based on subjective clinical
