Preoperative Screening for Obstructive Sleep Apnea Using Alternative Scoring Models of the Sleep Tiredness Observed...

Area of Science:

• Anesthesiology
• Sleep Medicine
• Respiratory Medicine

Background:

• The STOP-Bang questionnaire is a validated tool for preoperative screening of obstructive sleep apnea (OSA).
• Its moderate specificity for scores of 3-4 necessitates further validation and exploration of alternative scoring models.
• External validation is crucial to assess its real-world predictive performance.

Purpose of the Study:

• To externally validate the STOP-Bang questionnaire for obstructive sleep apnea (OSA) screening.
• To evaluate the effectiveness of proposed alternative scoring models in improving OSA prediction.
• To assess the performance of the STOP-Bang questionnaire in patients with intermediate (3-4) versus high (5-8) risk scores.

Main Methods:

• A prospective cohort study of 115 surgical patients with STOP-Bang scores ranging from 3 to 8.
• Moderate-to-severe OSA was diagnosed via Type 3 sleep recordings (apnea-hypopnea index >15).
• Patients were stratified into intermediate (STOP-Bang 3-4) and high-risk (STOP-Bang 5-8) subgroups; alternative scoring models were tested for the intermediate group.

Main Results:

• Moderate-to-severe OSA incidence was significantly higher in the high-risk group (78%) compared to the intermediate-risk group (53%) (P < .01).
• For patients with STOP-Bang scores of 3-4, alternative scoring models did not improve OSA diagnosis accuracy.
• The questionnaire demonstrated higher accuracy for scores of 5-8.

Conclusions:

• The STOP-Bang questionnaire effectively identifies moderate-to-severe OSA in patients with scores of 5-8.
• Its predictive performance is limited in patients with intermediate scores (3-4).
• Alternative scoring models failed to enhance the screening accuracy for patients with STOP-Bang scores of 3-4.