A pilot study to assess a novel screening questionnaire for central sleep apnea in patients undergoing overnight diagnostic polysomnography

Purpose: A novel central sleep apnea (CSA) screening questionnaire, SCOUTS-BAG-HARMS (SBH), was developed and assessed with polysomnography (PSG)-confirmed “any CSA”, defined as a central apnea index (CAI) ≥ 5 per hour. Unlike the STOP-BANG questionnaire, which screens for obstructive sleep apnea (OSA), SBH incorporates CSA-specific questions in three sections (SCOUTS), including silent apneas, demographics (BAG), including body mass index, and comorbidities (HARMS), including heart failure. Methods: In this pilot study, patients undergoing a PSG at our sleep lab between January and June 2023 were administered both the STOP-BANG and the SBH questionnaires. Questionnaire scores were compared to the CAI on in-lab PSG. Subset analysis assessed whether specific questions or sections of the SBH questionnaire have significant correlation with the finding of CAI ≥ 5 per hour. Results: Neither the STOP-BANG questionnaire nor the SBH questionnaire total score correlated linearly with the severity of CAI on PSG, but the SBH score ≥ 6 out of 20 correlated with the finding of CSA. On subset analysis, the HARMS section of SBH correlated with the finding of CSA on PSG. Adding the HARMS question responses to the total score on STOP-BANG also correlated with the finding of CSA. Conclusion: Since most patients with CSA also have some degree of obstructive type respiratory events, adding HARMS questions to the widely used STOP-BANG screening questionnaire for OSA may help identify patients at risk for CSA in the general population. This, in turn, would lead to prompt diagnostic testing and treatment for CSA.