Can STOP-Bang and Pulse Oximetry Detect and Exclude Obstructive Sleep Apnea?

Area of Science:

• Sleep Medicine
• Pulmonology
• Medical Diagnostics

Background:

• Obstructive sleep apnea (OSA) is a prevalent disorder linked to postoperative complications.
• A significant number of OSA cases remain undiagnosed, highlighting the need for accessible screening methods.

Purpose of the Study:

• To evaluate the efficacy of the STOP-Bang questionnaire and oxygen desaturation index in identifying individuals with OSA.
• To determine optimal screening thresholds for these tools in a clinical setting.

Main Methods:

• A prospective, observational multicenter trial involving 449 adult patients referred for OSA evaluation.
• Ambulatory polygraphy, including pulse oximetry, and the STOP-Bang questionnaire were administered.
• The STOP-Bang score assesses eight risk factors: Snoring, Tiredness, Observed apnea, high blood Pressure, BMI >35, Age >50, Neck circumference >40 cm, and Gender.

Main Results:

• An optimal STOP-Bang cutoff score of 6 demonstrated 63% sensitivity and 69% specificity for moderate to severe OSA (Apnea-Hypopnea Index [AHI] ≥15).
• A STOP-Bang score <2 had a 95% probability of excluding an AHI >15.
• A strong positive correlation was observed between AHI and both STOP-Bang score (ρ=0.50) and oxygen desaturation index (ρ=0.96).

Conclusions:

• The STOP-Bang questionnaire and pulse oximetry are valuable tools for screening obstructive sleep apnea.
• A STOP-Bang score <2 effectively rules out moderate to severe OSA, while a score ≥6 strongly suggests its presence.
• Integrating nightly pulse oximetry for patients with STOP-Bang scores of 2-5 is recommended for enhanced pre-surgical screening.