Validation of the STOP, STOP-BANG Questionnaire and Its Modifications for Screening Obstructive Sleep Apnea in Southern Thailand
Abstract
Objective: To evaluate the diagnostic performance of STOP, STOP-BANG, and their modifications against apnea-hypopnea index (AHI) cutoffs of ≥5 and ≥15.
Material and Methods: This retrospective cross-sectional study analyzed OSA patients (≥18 years) treated at the Dental Sleep Medicine Clinic, Prince of Songkla University, Thailand, from December 2007 to April 2021. Screening tools included STOP, STOP-BANG, and modified versions with different body mass index (BMI) and NC cutoffs. Patients were classified by AHI (≥5 and ≥15), and the accuracy of each questionnaire was evaluated against these thresholds.
Results: Of the 112 eligible patients, 66.1% were male, with a mean age of 46.9±11.9 years. For AHI ≥5, sensitivities were high: STOP (93.1%), STOP-BANG (89.8%), and modified STOP-BANG with BMI ≥30/NC ≥40 (90.8%), BMI ≥26/NC ≥40 (93.9%), and BMI ≥35/NC ≥35 (93.8%). Specificities were moderate: STOP (45.5%), STOP-BANG (54.5%), and 45.5% for all modified versions. For AHI ≥15, sensitivities remained high: STOP (91.3%), STOP-BANG (89.4%), BMI ≥30/NC ≥40 (87.9%), BMI ≥26/NC ≥40 (93.9%), and BMI ≥35/NC ≥35 (92.3%). However, specificities were low: STOP (14.0%), STOP-BANG (16.3%), modified STOP-BANG with BMI ≥ 30/NC ≥ 40 (18.6%), BMI ≥26/NC ≥40 (16.3%), and BMI ≥35/NC ≥35 (14.3%).
Conclusion: The modified STOP-BANG (BMI ≥26 kg/m², NC ≥40 cm) showed the highest sensitivity and may be the most suitable OSA screening tool in our region.
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