Toward developing more effective screening questionnaires for obstructive sleep apnoea: a conceptual model and testing

Purpose ‘Paper-and-pencil’ questionnaires are essential tools for the preliminary screening of obstructive sleep apnoea (OSA), a condition that is rapidly becoming more common yet often remains underdiagnosed. The most commonly used simple tests were developed several decades ago and require updating. This research aims to gain a better understanding of the various factors that contribute to the development of OSA. Methods A total of 911 patients participated in the study and completed a self designed questionnaire that assessed their perceptions of the intensity of various risk factors for OSA, associated comorbid conditions, sleep quality, and lifestylerelated characteristics. Following this, polysomnography was conducted to objectively evaluate the severity of OSA. The relationships among predisposing and contributing factors, as well as the perceived symptoms of OSA, were analysed using partial least squares regression. Results Our findings emphasise the crucial roles of sex, body mass index, age, and the presence of gastroesophageal reflux disease in the development of OSA. Therefore, questions about these factors should be included in a future, updated questionnaire. The relationships between sleep quality, quality of life, and OSA is highly complex; both their values and the directions of their regression parameters vary significantly between OSA patients and those without OSA. It is possible to distinguish OSA patients with 91.87% accuracy, achieving high sensitivity (78.2%) and specificity (96.5%), based on the structure of path and regression coefficients. Conclusions Our findings indicate opportunities for developing more effective and targeted questionnaires that remain relatively simple without being overly simplified. We discovered that a two-step question format could yield the most beneficial outcomes.