John de Heide

Undiagnosed OSA and AF recurrence after ablation (OSA-AF study) 55 number of apneas was ≥ 50%, these patients were considered to have predominant central sleep apnea; otherwise, they had predominant obstructive sleep apnea. 2.4. SDB screening questionnaires Enrolled patients were requested to complete two questionnaires: the STOP-BANG and ESS questionnaire. The STOP-BANG questionnaire is specifically developed as a screening tool for SDB (18). It consists of 8 dichotomous items related to the clinical features of SDB, with a total score ranging from 0 to 8. Intermediate risk is defined as 3–4 points, and high risk is defined as ≥ 5 points or as 2 points in the first 4 questions in combination with male sex, obesity (BMI > 35 kg/m2) or wide neck circumference (>40 cm females, >42 cm males). An intermediate or high-risk STOPBANG score was considered abnormal in this study. The ESS is a validated questionnaire to screen for excessive daytime sleepiness, which is an important symptom to refer patients for SDB screening (19). It consists of 8 questions related to falling asleep in several common situations, each scored with a degree of severity ranging from 0 to 3. Scores range from 0 (least sleepy) to 24 (sleepiest). Excessive daytime sleepiness was defined in this study as an ESS ≥ 11. 2.5. Statistical analysis Continuous parameters are presented as mean ± standard deviation (SD) or as median and interquartile range (IQR), as appropriate. Categorical data are presented as frequencies and percentages. Comparisons between groups were performed with an independent Student t-test, Mann-Whitney U test, chi-square test, or Fisher exact test, where appropriate. In case of comparing>2 groups, one-way ANOVA or KruskalWallis test was used to compare continuous variables, where appropriate. Outcomes of logistic regression analysis are presented as odds ratios (OR) and 95% confidence intervals (CI). A P-value < 0.05 was considered statistically significant. Statistical analyses were performed using SPSS software (SPSS, version 25; IBM, Chicago, Illinois). 2.6. Ethics The Medical Ethics Committee reviewed the study (MEC-2018–1503), and this single-center cohort study was not subjected to the Dutch Medical Research Involving Human Subjects Act. All participants undergoing SDB screening provided 4

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