Validity of the New "Top End Sleepiness Scale" (TESS) against the STOP-Bang Tool in Predicting Obstructive Sleep Apnoea among Indigenous Australian Adults.

Abstract

BACKGROUND: The validity of the newly developed sleepiness assessment tool the "Top End Sleepiness Scale" (TESS) against other established obstructive sleep apnea (OSA) screening tools has not been evaluated. AIMS: To compare the utility and validity of the culturally safe and clinically relevant subjective daytime sleepiness assessment tool the "TESS" for use among Indigenous Australians against STOP-Bang screening tool in predicting OSA in a regional and remote Indigenous Australian cohort. METHODS: The TESS questionnaire consisting of pictorial representations of six items representing daily activities that would induce daytime sleepiness specific for Indigenous Australians was assessed for its correlation in predicting moderate to severe OSA according to apnea hypopnea index (AHI, ≥15) against STOP-Bang screening tool. RESULTS: Eighty Indigenous Australian patients (51% male, mean age 45.1 ± 11.5 years were included in this study with the majority (n=70, 88%) having OSA of which 65 (93%) had an AHI ≥15. AUC statistics for overall scores showed no significant difference between TESS or STOP-Bang in the prediction of OSA (p=0.16). A moderate risk score of TESS (≥3) was superior to the STOP-Bang (score 3-4) in sensitivity (84% vs. 33%) and specificity (39% vs. 30%). The sensitivity for a high risk score for the STOP-Bang (≥5) was superior to the TESS (≥8) (60% vs. 33%), though specificity was comparable (83% vs. 91% respectively). CONCLUSIONS: The TESS screening tool could be a useful standalone or could be adopted alongside STOP-Bang OSA screening tools in the clinical assessment of sleep disorders among Indigenous Australians. This article is protected by copyright. All rights reserved.