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Published on: December 6, 2016
The Predictive Performance of the STOP-Bang Questionnaire in Obstructive Sleep Apnea Screening of Obese Population at
Haluk Mergen1, Burak Altındağ1, Zeynep Zeren Uçar2
1Family Medicine, University of Health Sciences, Izmir Tepecik Health Practice & Research Center, Izmir, TUR.
Abstract:
Background The prevalence of obstructive sleep apnea (OSA) is high in the obese population. In this study, it was aimed to fulfill the STOP-Bang questionnaire which is a concise and easy-to-use questionnaire for OSA screening in obese patients. Materials & methods This is a retrospective study where the patients, who planned polysomnography, were referred to sleep clinic. Patients were screened for OSA by the STOP-Bang questionnaire. Laboratory polysomnography was performed in 275 patients. Patients with BMI ≥ 30 were taken into study. The screening test was evaluated by three different risk analysis such as, a STOP score, a STOP-Bang score and a modified STOP-Bang score. The predictive parameters (sensitivity, specificity, and positive and negative predictive values) for alternative scoring models in obese patients were analyzed. Results In 217 obese patients, a STOP score cutoff of 3 and a STOP-Bang score cutoff of 4 provides a better balance of sensitivity and specificity for all OSA (apnea-hypopnea index [AHI] ≥ 5). The STOP questionnaire revealed a sensitivity of 87.9% and a positive predictive value of 99.5% for patients with all OSA (p: 0.005). The STOP-Bang scoring model revealed a sensitivity of 95.3% and a positive predictive value of 99.5% for patients with all OSA (p < 0.001). The modified STOP-Bang scoring revealed a sensitivity of 95.8% and a positive predictive value of 99.5% for patients with all OSA (p < 0.001). The area under the curve of the STOP-Bang for identifying mild, moderate and severe OSA was 0.581, 0.652 and 0.675, respectively. Whereas according to the STOP-Bang, all morbid obese patients (obesity class III, n: 47) were at high risk of OSA. Conclusion This study suggests that the STOP-Bang questionnaire for obstructive sleep apnea screening in obese patients is a high sensitivity and appropriate screening test.
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