Chest
Volume 149, Issue 3, March 2016, Pages 631-638
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Commentary
STOP-Bang Questionnaire: A Practical Approach to Screen for Obstructive Sleep Apnea

https://doi.org/10.1378/chest.15-0903Get rights and content
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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/m2 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.

Key Words

obstructive sleep apnea
perioperative care
screening questionnaire
sleep-disordered breathing

Abbreviations

AHI
apnea-hypopnea index
NPV
negative predictive value
PPV
positive predictive value
PSG
polysomnogram
STOP-Bang
snoring, tiredness, observed apnea, high BP, BMI, age, neck circumference, and male gender

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