Participants with severe OSA were more likely to have higher BMIs and anthropometric measurements: neck circumference, waist circumference, height, and weight, which underscores the role of obesity and stature in the degree of OSA. BMI cutoffs have been shown not to accurately reflect different types of obesity in different ethnic and racial groups or by sex. Additionally, accurate weights may be difficult to obtain from individuals who do not have a scale or refuse to have their weight taken due to society shaming. Some individuals are not comfortable in determining or disclosing their BMI, if known. Furthermore, many individuals live alone and do not have a sleep witness for snoring and apneas, which are required item of the SBQ.
The NHR is a statistically sound alternative method for screening individuals for MS-OSA. In both the derivation and validation samples, the SNs were higher for the NHR and WHR
than for the dSBQ for MS-OSA; however, the dSBQ correctly classified more participants than did the NHR and WHR, due to a higher SP than that of the NHR or WHR. However, when using list wise comparisons for the AUCs, the NHR and dSBQ were not statistically different for MS-OSA prediction.
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