Analyzing Neck Circumference as an Indicator of CPAP Treatment Response in Obstructive Sleep Apnea with Network Medicine

We explored the relationship between obstructive sleep apnea (OSA) patients’ anthropometric measures and the CPAP treatment response. To that end, we processed three non-overlapping cohorts ([Formula: see text] , [Formula: see text] , [Formula: see text]) with 1046 patients from four sleep laboratories in Western Romania, including 145 subjects ([Formula: see text]) with one-night CPAP therapy. Using [Formula: see text] data, we created a CPAP-response network of patients, and found neck circumference (NC) as the most significant qualitative indicator for apnea–hypopnea index (AHI) improvement. We also investigated a quantitative NC cutoff value for OSA screening on cohorts [Formula: see text] (OSA-diagnosed) and [Formula: see text] (control), using the area under the curve. As such, we confirmed the correlation between NC and AHI ([Formula: see text] , [Formula: see text]) and showed that 71% of diagnosed male subjects had bigger NC values than subjects with no OSA (area under the curve is 0.71, with 95% CI 0.63–0.79, [Formula: see text]); the optimal NC cutoff is 41 cm, with a sensitivity of 0.8099, a specificity of 0.5185, positive predicted value (PPV) = 0.9588, negative predicted value (NPV) = 0.1647, and positive likelihood ratio (LR+) = 1.68. Our NC [Formula: see text] cm threshold classified the [Formula: see text] patients’ CPAP responses—measured as the difference in AHI prior to and after the one-night use of CPAP—with a sensitivity of 0.913 and a specificity of 0.859.