Accuracy of Neck Circumference in Predicting the Severity of Obstructive Sleep Apnea at Pranangklao Hospital

Abstract

Background: Obesity is associated with the occurrence of obstructive sleep apnea (OSA) and neck fat. The diagnosis of OSA, typically uses the body mass index (BMI), which reflects overall fat distribution but not specifically indicate neck fat. Neck circumference can be inferred as an indicator of fat distribution and body shape within the population. Objective: This study aims to investigate the relationship between neck circumference and the severity of OSA, as well as to determine the appropriate cutoff point for neck circumference in predicting the severity of OSA at Pranangklao Hospital. Methods: This retrospective study included patients diagnosed with OSA between January 2021 and April 2024, totaling 64 cases. Data were collected using created record form. Relationships were analyzed using Chi-square or Fisher's exact test for categorical variables and one-way ANOVA for continuous variables. The appropriate cutoff point for neck circumference was determined using diagnostic tests, displaying sensitivity, specificity and the area under the receiver operating characteristic curve (AUROC). Results: Among the 64 patients diagnosed with OSA between January 2021 and April 2024, there were 13 cases (20.32%) with mild severity, 14 cases (21.87%) with moderate severity, and 37 cases (57.81%) with severe OSA. The analysis using one-way ANOVA revealed that neck circumference was significantly associated with the severity of OSA (p<0.01). For moderate OSA patients, the cutoff point for neck circumference was 37.5 cm, with a sensitivity of 73%, specificity of 85%, and ROC of 79%. For severe OSA patients, the cutoff point was 38.5 cm, with a sensitivity of 73%, specificity of 74%, and ROC of 74%. Conclusion: Neck circumference is associated with the severity of obstructive sleep apnea (OSA). It is necessary to redefine the appropriate neck circumference for predicting OSA severity specifically for the Thai population. Identifying an optimal neck circumference cutoff point for predicting OSA severity in the Thai population is highly beneficial, as an accurate cutoff point can significantly aid in the diagnosis and treatment of OSA. Therefore, analyzing and developing appropriate OSA screening tools for the Thai population is crucial for effective health care and disease prevention in Thailand.