title: Evaluation of the Arabic version of STOP-Bang questionnaire as a screening tool for obstructive sleep apnea.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is underdiagnosed. OSA is usually diagnosed by polysomnography (PSG) and, if untreated, could lead to life-threatening complications. Many screening questionnaires have been developed to screen and identify patients at high risk for OSA. This study aimed to evaluate and validate the Arabic version of Stop-Bang questionnaire as a screening tool for patients with OSA symptoms referred to a sleep clinic.
  
  
  METHODS
  All referred Arabic-speaking adult patients presenting to a Sleep Disorders Specialized Clinic in Al Ain for PSG were requested to complete an Arabic STOP-Bang questionnaire. A score of 3 or more out of a possible 8 was taken to indicate high risk for presence of OSA. These scores were then evaluated versus results from the overnight, monitored PSG. Apnea/hypopnea index (AHI) of ≥5/h was considered for diagnosis of OSA.
  
  
  RESULTS
  One hundred ninety-three sleep clinic patients were enrolled in this study. PSG was positive (AHI ≥5) in 85 % of the studied population. STOP-Bang questionnaire was positive (≥3) in 87 % of the population. Reproducibility of STOP-Bang questionnaire was tested, and the intraclass correlation coefficient of the total score of STOP-Bang questionnaire was 0.931 (95 % CI 0.834-0.972). The sensitivities of the STOP-Bang screening tool for an AHI of ≥5, ≥15, and ≥30 were 90, 96.75, and 99.70 %, respectively, with negative predictive values (NPVs) of 36, 84, and 92 %, respectively. ROC curve was 0.77.
  
  
  CONCLUSIONS
  The Arabic version of STOP-Bang questionnaire is an easy-to-use tool that can be implemented as a reliable, quick screening tool for OSA in patients referred to sleep clinic. It demonstrated high sensitivity and NPV especially for patients with moderate to severe OSA. We believe that this tool will help physicians to earlier identify cases at risk of OSA.
authors.affiliation: Tawam Hospital, Abu Dhabi, United Arab Emirates. Houqani@gmail.com.
authors.forename: Shaikha
authors.initials: S
authors.lastname: Alhouqani
authors.affiliation: Ambulatory Health Services, Abu Dhabi, United Arab Emirates. malmanhali@hotmail.com.
authors.forename: Mariam
authors.initials: M
authors.lastname: Al Manhali
authors.affiliation: Nursing Research, Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Abu Dhabi, United Arab Emirates. a.alessa@uaeu.ac.ae.
authors.forename: Awad
authors.initials: A
authors.lastname: Al Essa
authors.affiliation: College of Medicine and Health Sciences, UAE University, P.O.Box 17666, Al Ain, Abu Dhabi, United Arab Emirates. alhouqani@uaeu.ac.ae.
authors.forename: Mohammed
authors.identifier: http://orcid.org/0000-0003-4481-3911
authors.initials: M
authors.lastname: Al-Houqani
mesh_terms: D000328:Adult; D000368:Aged; D003431:Cross-Cultural Comparison; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D014175:Translating; D014479:United Arab Emirates; D055815:Young Adult
keywords: Obstructive sleep apnea; STOP-Bang; Screenings; Validation