Exploring the STOP-BANG questionnaire for obstructive sleep apnea screening in seniors

Area of Science:

• Gerontology
• Sleep Medicine
• Diagnostic Accuracy

Background:

• Obstructive sleep apnea (OSA) screening accuracy may vary in seniors due to age-related changes in predictive factors like sex, age, and BMI.
• The STOP-BANG questionnaire is a common OSA screening tool, but its performance in older populations requires specific investigation.

Purpose of the Study:

• To evaluate the diagnostic performance of the STOP-BANG questionnaire in older adults (≥65 years).
• To assess aging-adapted scoring and thresholds for OSA screening in seniors.
• To investigate a modified STOP-BANG questionnaire (STOP-B28) for improved OSA screening in this demographic.

Main Methods:

• 458 community-dwelling adults aged 65+ were screened for OSA using the STOP-BANG questionnaire.
• The questionnaire's performance was compared against the apnea-hypopnea index (AHI) from home sleep apnea testing (HSAT).
• The STOP-B28 (STOP + BMI > 28 kg/m²) and supplementary scales (ESS, AIS) were evaluated.

Main Results:

• The STOP-BANG and STOP-B28 demonstrated similar areas under the curve (AUC) of 0.64 for predicting AHI ≥ 5 events/h.
• STOP-B28 showed comparable performance to STOP-BANG with fewer inputs, proving useful for OSA exclusion.
• ESS and AIS were not significant as supplementary screening tools.

Conclusions:

• The STOP-B28 offers a simpler, effective alternative to STOP-BANG for OSA screening in seniors.
• Questionnaire-based OSA screening in seniors presents challenges, suggesting objective tests like HSAT may be a preferred initial step.
• Objective testing is recommended as a primary approach for OSA investigation in the elderly population.