Heraganahally, Subash S; Howarth, Timothy P; Wirth, Hugh; Short, Teagan; Benn, Edmund

doi:10.1111/imj.15633

Author(s)

Heraganahally, Subash S

Howarth, Timothy P

Wirth, Hugh

Short, Teagan

Benn, Edmund

Publication Date

2021-11-20

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.

Affiliation

College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.

Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Tiwi, Darwin, Northern Territory, Australia.

Darwin Respiratory and Sleep Health, Darwin Private Hospital, Tiwi, Darwin, Northern Territory, Australia.

College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia.

Citation

Intern Med J. 2021 Nov 20. doi: 10.1111/imj.15633.

OrcId

0000-0003-0788-7137

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/34800328/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/11962

Title

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

Type of document

Journal Article

Entity Type

Publication

Author(s)	Heraganahally, Subash S Howarth, Timothy P Wirth, Hugh Short, Teagan Benn, Edmund
Publication Date	2021-11-20
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.
Affiliation	College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia. Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Tiwi, Darwin, Northern Territory, Australia. Darwin Respiratory and Sleep Health, Darwin Private Hospital, Tiwi, Darwin, Northern Territory, Australia. College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia.
Citation	This article is protected by copyright. All rights reserved. Intern Med J. 2021 Nov 20. doi: 10.1111/imj.15633.
OrcId	0000-0003-0788-7137
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/34800328/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/11962
Title	Validity of the New "Top End Sleepiness Scale" (TESS) against the STOP-Bang Tool in Predicting Obstructive Sleep Apnoea among Indigenous Australian Adults.
Type of document	Journal Article
Entity Type	Publication

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

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