• Chest · Jun 2016

    Sex-Specific Prediction Models for Sleep Apnea from the Hispanic Community Health Study/Study of Latinos.

    • Neomi Shah, David B Hanna, Yanping Teng, Daniela Sotres-Alvarez, Martica Hall, Jose S Loredo, Phyllis Zee, Mimi Kim, H Klar Yaggi, Susan Redline, and Robert C Kaplan.
    • Albert Einstein College of Medicine, Bronx, NY. Electronic address: Neomi.Shah@mssm.edu.
    • Chest. 2016 Jun 1; 149 (6): 1409-18.

    ObjectiveWe developed and validated the first-ever sleep apnea (SA) risk calculator in a large population-based cohort of Hispanic/Latino subjects.MethodsCross-sectional data on adults from the Hispanic Community Health Study/Study of Latinos (2008-2011) were analyzed. Subjective and objective sleep measurements were obtained. Clinically significant SA was defined as an apnea-hypopnea index ≥ 15 events per hour. Using logistic regression, four prediction models were created: three sex-specific models (female-only, male-only, and a sex × covariate interaction model to allow differential predictor effects), and one overall model with sex included as a main effect only. Models underwent 10-fold cross-validation and were assessed by using the C statistic. SA and its predictive variables; a total of 17 variables were considered.ResultsA total of 12,158 participants had complete sleep data available; 7,363 (61%) were women. The population-weighted prevalence of SA (apnea-hypopnea index ≥ 15 events per hour) was 6.1% in female subjects and 13.5% in male subjects. Male-only (C statistic, 0.808) and female-only (C statistic, 0.836) prediction models had the same predictor variables (ie, age, BMI, self-reported snoring). The sex-interaction model (C statistic, 0.836) contained sex, age, age × sex, BMI, BMI × sex, and self-reported snoring. The final overall model (C statistic, 0.832) contained age, BMI, snoring, and sex. We developed two websites for our SA risk calculator: one in English (https://www.montefiore.org/sleepapneariskcalc.html) and another in Spanish (http://www.montefiore.org/sleepapneariskcalc-es.html).ConclusionsWe created an internally validated, highly discriminating, well-calibrated, and parsimonious prediction model for SA. Contrary to the study hypothesis, the variables did not have different predictive magnitudes in male and female subjects.Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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