Obstructive sleep apnea in pregnancy: reliability of prevalence and prediction estimates

OBJECTIVE; We sought to ascertain the validity of two screening scales for obstructive sleep apnea (QSA) in: pregnancy and to establish the prevalence of OSA in pregnancy. STUDY DESIGN: In this prospective Observational study, two screening scales were administered. Screen positive Subjects were referred for diagnostic polysomnography (PSG); if admitted for antepartum care; screen positive subjects underwent a modified study with a type 3 device (T3D). RESULT: A total of 1509 subjects underwent OSA screening; 58 completed diagnostic testing. Neither measure was a reliable diagnostic tool for OSA as determined by T3D or PSG (detection rates of 10.3% and 18.0%, respectively). Among screen positive subjects undergoing PSG or T3D testing, 15.5% ultimately met 'gold standard' OSA diagnostic criteria for an estimated point Prevalence of 4.9%. CONCLUSION: In this prospective trial, screening positive on the Berlin questionnaire or Epworth sleepiness scale was poorly predictive of OSA among gravidae and was associated with a high false referral rate.