Abstract
Introduction: STOP-BANG (Snoring, Tiredness during daytime, Observed apnea, High blood Pressure, Body mass index >35, Age >50, Neck circ >40 cm, Gender) score has been shown to be a useful tool to screen for obstructive sleep apnea (OSA) during preoperative evaluation. The aim of our study is to evaluate the performance of this score for detecting OSA in a large sample of middle-aged general population.
Methods: 458 subjects (47.7% women, 50.6±7.5 years old, BMI 25.2±4.9 kg/m2) participating in an ongoing population-based cohort study (HypnoLaus, Lausanne, Switzerland) underwent a complete polysomnography at home. Apnea hypopnea index (AHI) was scored acording to AASM 2007 criteria. A STOP-BANG score of 3 or more out of a possible 8 was considered suggestive of OSA.
Results: Mean AHI was 6.04±10.3/h. Prevalence of OSA defined as an AHI >5/h, 15/h and 30/h was 33.0%, 9.39% and 3.49%, respectively in our population. Mean STOP-BANG score was 2.16±1.37. 34.9% of the subjects had a score ≥3. To detect OSA with AHI thresholds of 5/h, 15/h and 30/h, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were respectively 55.6%, 75.2%, 52.5% and 77.5% for an AHI >5/h; 76.7%, 69.4%, 20.6% and 96.6% for an AHI>15; 93.8%, 67.2%, 9.4% and 99.7% for an AHI>30/h. The area under the ROC curve for whole STOP-BANG score was 0.7 for an AHI> 5/h, 0.775 for an AHI>15/h and 0.871 for an AHI >30/h.
Conclusion: STOP-BANG score appears to be a useful clinical tool to rule out severe OSA (AHI>30/h) in a selected population, with a high negative predictive value. However, it is not an adequate screening tool for OSA in the general population due to its poor sensitivity.
- © 2011 ERS