Validation of the STOPBANG Questionnaire among Patients Referred for Suspected Obstructive Sleep Apnea

Abstract

Background The STOP-BANG is a simple obstructive sleep apnea (OSA) screening tool, part questionnaire (STOP) and part demographic or physical measures (BANG), developed for use in preoperative surgical clinics. This study assessed sensitivity and specificity of the instrument among patients referred to a sleep disorders laboratory, and also its performance characteristics when BANG physical measures are patient-reported rather than measured. Methods Adults referred for diagnostic polysomnography completed the STOP questions and answered four yes/no questions (BANG self-reported) about their body mass index (weight and height), age, neck circumference, and gender, which were also assessed by laboratory technologists (BANG-measured). Results Among N=219 subjects (mean age 46.3 ± 13.9 [s.d.] years; 98 [44.8%] males) the sensitivity of the STOP-BANG measured for an apnea/hypopnea index (AHI, events per hour of sleep) >5, >15, and >30 was 82, 93, and 97% respectively. Corresponding negative predictive values were 44, 87, and 96%. Specificities were comparatively low (48, 40, and 33%). The STOP-BANG measured and STOP-BANG self-reported scores showed essentially equivalent test characteristics against polysomnography. Conclusions The STOP-BANG appears to have limited utility in a referred, sleep laboratory setting. Negative results help to identify some individuals as unlikely to have moderate-to-severe apnea, and may thereby prove useful in identification of patients who would benefit more from laboratory studies than home studies. A STOP-BANG in which all information is self-reported may be as effective as the original version, and has potential to facilitate research or community screening where good negative predictive value is required for an effective screening tool.

The Validity and Reliability of an Arabic Version of the STOP-Bang Questionnaire for Identifying Obstructive Sleep Apnea

“…Chung et al ., who validated the SBQ primarily among preoperative patients, reported sensitivities of 72.1%, 78.6% and 87.2% for AHIs of > 5, > 15 and > 30/hour, respectively, with corresponding specificities of 38.2%, 37.4% and 36.2% [ 10 ]. Subsequent studies have validated this questionnaire in patients attending sleep disorders clinics [ 17 ]. Vana et al .…”

Photoplethysmographic Signal to Screen Sleep-Disordered Breathing in Hospitalized Heart Failure Patients

“…But, although the STOP-BANG questionnaire may have low specificity, in our model it served as an effective awareness tool among house staff and admitting physicians. In addition, it can be self-administered (14). Also, the screening pathway is obstructive sleep apnea specific, and central sleep apnea might be under-represented.…”

“…Patients admitted were screened by a trained respiratory therapist for SDB-related symptoms using the STOP-BANG questionnaire. The questionnaire included the following measurements: heavy snoring, tiredness, observed apneas, hypertension, body mass index [BMI] >35 kg/m 2 , age >50 years, neck circumference >40 cm, and male sex (13,14). For patients who exhibited sleep-related symptoms (positive for $3 items on the questionnaire), the admitting team was notified and a sleep consult was recommended.…”

The critical influence of nocturnal breathing complaints on the quality of sleep after stroke: the Pittsburgh Sleep Quality Index and STOP-BANG

“…Furthermore, patients have relatively little difficulty in answering it, giving a high overall response rate 26 . The identification of impaired sleep quality and frequency of sleep disturbances in patients with stroke can lead to corrective measures, such as the establishment of proper routines and habits, as well as more appropriate time for therapeutic interventions 27,28 .…”