STOP questionnaire: a tool to screen patients for obstructive sleep apnea

Area of Science:

• Anesthesiology and Perioperative Medicine
• Sleep Medicine
• Medical Device Development

Background:

• Obstructive sleep apnea (OSA) is a significant risk factor for adverse events during surgery.
• No validated screening tool currently exists for OSA in surgical patient populations.
• Developing a reliable screening method is crucial for patient safety.

Purpose of the Study:

• To develop and validate a concise, user-friendly questionnaire for screening OSA in surgical patients.
• To assess the diagnostic accuracy of the developed tool.
• To evaluate the impact of incorporating demographic and clinical factors on screening sensitivity.

Main Methods:

• A four-question screening tool (STOP) was developed using factor analysis and pilot testing in preoperative patients (≥18 years).
• The STOP questionnaire assesses snoring, daytime tiredness, observed apnea, and hypertension.
• Validation involved comparing STOP scores against apnea-hypopnea index (AHI) from polysomnography in 177 patients.

Main Results:

• The STOP questionnaire identified 27.5% of 2,467 patients as high risk for OSA.
• In the validation group, STOP sensitivities for AHI >5, >15, and >30 were 65.6%, 74.3%, and 79.5%, respectively.
• Incorporating BMI, age, neck circumference, and gender increased sensitivities to 83.6%, 92.9%, and 100% for the same AHI cutoffs.

Conclusions:

• The STOP questionnaire is a validated, simple tool for preoperative OSA screening in surgical patients.
• The tool demonstrates high sensitivity, particularly for moderate to severe OSA when combined with clinical factors.
• This validated tool can aid in identifying at-risk patients for timely intervention.