STOP-Bang Questionnaire

Abstract

There exists a high prevalence of OSA in the general population, a great proportion of which remains undiagnosed. The snoring, tiredness, observed apnea, high BP, BMI, age, neck circumference, and male gender (STOP-Bang) questionnaire was specifically developed to meet the need for a reliable, concise, and easy-to-use screening tool. It consists of eight dichotomous (yes/no) items related to the clinical features of sleep apnea. The total score ranges from 0 to 8. Patients can be classified for OSA risk based on their respective scores. The sensitivity of STOP-Bang score ≥ 3 to detect moderate to severe OSA (apnea-hypopnea index [AHI] > 15) and severe OSA (AHI > 30) is 93% and 100%, respectively. Corresponding negative predictive values are 90% and 100%. As the STOP-Bang score increases from 0 to 2 up to 7 to 8, the probability of moderate to severe OSA increases from 18% to 60%, and the probability of severe OSA rises from 4% to 38%. Patients with a STOP-Bang score of 0 to 2 can be classified as low risk for moderate to severe OSA whereas those with a score of 5 to 8 can be classified as high risk for moderate to severe OSA. In patients whose STOP-Bang scores are in the midrange (3 or 4), further criteria are required for classification. For example, a STOP-Bang score of ≥ 2 plus a BMI > 35 kg/m(2) would classify that patient as having a high risk for moderate to severe OSA. In this way, patients can be stratified for OSA risk according to their STOP-Bang scores.

Authors’ response (November 28, 2017) to the letter to the Editor (November 15, 2017) concerning the paper “Screening commercial drivers for obstructive sleep apnea: Validation of STOP-Bang questionnaire”

“…Drivers found to be in the high risk of moderate and severe OSA must be further examined and treated; hence our strong focus on these levels of OSA severity. The data on appropriateness of screening for (not diagnosing) moderate or severe OSA with the STOP-Bang questionnaire may be found in several studies covering varied target populations (general population, sleep clinic, commercial drivers), as explained by the questionnaire author [6]. In our study we also clearly identified the issue of low specificity of the STOP-Bang and the potential solutions for that issue.…”

“…In our study we also clearly identified the issue of low specificity of the STOP-Bang and the potential solutions for that issue. We agree with the author of the letter that there are further possibilities of improving the predictive properties of the STOP-Bang questionnaire, including body type (apple vs. pear), serum bicarbonates level, alternative scoring models, etc., [6,7], but in our study, the main focus was on translation and validation of the original STOP-Bang scoring model in the population of the commercial drivers. In our opinion, this paper has shed some light on the subject of usefulness of the standard OSA screening questionnaire in the population of commercial drivers.…”

Depressive Symptoms and Sleep Efficiency Sequentially Mediate Racial Differences in Temporal Summation of Mechanical Pain

“…The STOP-BANG consists of eight yes/no questions, scored 0 = no/1 = yes (range 0–8). The STOP-BANG assesses for major risk factors of OSA including snoring, daytime fatigue, and high blood pressure, external observation of the participant not breathing while sleeping, a body mass index (BMI) >35kg/m2, age over 50 years, neck circumference > 16 inches, and male gender (36). Risk for OSA is considered high if the participant answers “yes” to 5 or more of the questions.…”

Identification of significant obstructive sleep apnoea in the obese patient: development of the novel DX-OSA score

“…Three screening tools for identifying OSA in a preoperative setting [22] have been validated in surgical patients: the Berlin Questionnaire [4], the American Society of Anesthesiologists' Checklist [15], and the STOP-Bang Questionnaire [23][24][25]. Their sensitivity varies from 50 to 90%, depending upon the OSA severity targeted, but all have suboptimal specificity (30-60%) [26,27].…”