STOP-BANG Score as a Guide for Split-night Polysomnography

Abstract

Background and Objective: STOP-BANG questionnaire is a well-known obstructive sleep apnea (OSA) screening tool. This study aimed to evaluate that patients with high probability of OSA in STOP-BANG questionnaire meet the criteria for assessment by split-night polysomnography (PSG).
Materials and Methods: Patients who were admitted to three sleep clinics and underwent full-night PSG entered into the study. The patients filled in the STOP questionnaire at their first clinic visit. Weight, height, and neck circumference were measured by technicians for computing STOP-BANG score. The apnea–hypopnea index (AHI) was used for diagnosis of OSA for which 5 ≤ AHI < 15, 15 ≤ AHI < 30, and AHI ≥ 30 were considered as mild, moderate, and severe OSA, respectively. AHI cutoff levels of 20 and 40 were used to evaluate split-night PSG criteria. Sensitivity analysis was performed for identifying predictive parameters.
Results: In assessment of 990 patients, the sensitivity of the STOP-BANG ≥ 3 for OSA diagnosis at AHI thresholds of 5, 15 and 30 were 93, 96 and 97.8, and the specificity were 39, 24.5 and 20, respectively. The specificities of the STOP-BANG score ≥ 7 for OSA diagnosis at AHI thresholds of 20 and 40 were 99.2 and 97.9, and the positive predictive values were 90.5 and 64.3, respectively.
Conclusion: We found that the STOP-BANG could be considered not only as an OSA screening test, but also as a test to determine proper patients for split-night PSG, the benefit of which is a cost reduction in OSA management.