Predicting obstructive sleep apnea using the STOP-Bang questionnaire in the general population

Area of Science:

• Sleep Medicine
• Respiratory Medicine
• Clinical Diagnostics

Background:

• Obstructive sleep apnea (OSA) is a prevalent condition often undiagnosed.
• Screening tools are crucial for early detection, particularly in primary care settings.
• The STOP-Bang questionnaire is a widely used tool for OSA screening.

Purpose of the Study:

• To evaluate the diagnostic accuracy of the STOP-Bang questionnaire for obstructive sleep apnea (OSA) in a general population.
• To assess the STOP-Bang questionnaire's validity in predicting moderate-to-severe and severe OSA.
• To determine optimal Body Mass Index (BMI) cutoffs for Asian populations.

Main Methods:

• A population-based cohort of 242 subjects underwent home sleep testing using a type 3 monitor.
• Subjects completed the STOP-Bang questionnaire, and clinical data including BMI, age, neck circumference, and sex were recorded.
• Apnea-Hypopnea Index (AHI) was calculated to define OSA severity.

Main Results:

• The STOP-Bang questionnaire demonstrated a sensitivity of 66.2% for moderate-to-severe OSA (AHI ≥15) and 69.2% for severe OSA (AHI ≥30).
• Negative predictive values were high (85% for moderate-to-severe OSA, 94.8% for severe OSA).
• Adjusting BMI cutoffs for Asian populations did not significantly enhance the questionnaire's performance.

Conclusions:

• The STOP-Bang questionnaire is a valuable screening tool for obstructive sleep apnea (OSA) in the general population.
• Its moderate sensitivity and high negative predictive value support its use for identifying individuals at risk.
• The original BMI cutoff of >35 is appropriate for Asian populations, as lower thresholds did not improve accuracy.