STOP-BANG Score versus Epworth Sleepiness Scale as a Screening Tool for Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a common sleep-breathing disorder. OSA is becoming highly prevalent, which means that to detect and prevent various hazardous complications, it is imperative that there are easy yet accurate techniques available to identify people with OSA.

The objective was to compare two questionnaires: The STOP-BANG score and the Epworth Sleepiness Scale (ESS), used to screen the patients suspected of OSA. Polysomnography (PSG), the gold standard investigation, was used to diagnose OSA.

Sixty-five suspected individuals were recruited as per inclusion/exclusion criteria. Detailed history taking, physical examination, and anthropometric examination were done in all patients. Suspects were subjected to filling up of the STOP-BANG and ESS questionnaires, following which they underwent an overnight PSG examination, which is considered the gold standard diagnostic investigation for OSA. Compiled data were used to compare the sensitivities, specificities, and positive and negative predictive values (NPVs) of the two screening scores.

Of 65 screened patients, 57 (88%) had OSA. The sensitivity to predict OSA was the highest for the STOP-BANG questionnaire (91.23%), whereas ESS had a sensitivity of 70.18%. No difference in specificity (75%) of the two scores was noted. The positive predictive values of STOP-BANG and ESS questionnaires was 96.30% and 95.20%, respectively. NPV of STOP-BANG and ESS was 54.50% and 26.10%, respectively.

The present study was able to provide valuable insights into OSA screening. Out of the two studied OSA screening questionnaires, we found out that both had comparatively good predictive and diagnostic accuracy, with the STOP-BANG score surpassing the ESS score in the majority of measures. Considering the high global burden of undiagnosed OSA, there is a need to upregulate the screening for OSA followed by appropriate treatment measures. This would improve sleep quality and reduce the risk of complications and future adverse health outcomes.