title: Predicting obstructive sleep apnea using the STOP-Bang questionnaire in the general population.
abstract: The STOP-Bang questionnaire was developed as a quick and simple screening tool for obstructive sleep apnea (OSA) in preoperative clinics. We aimed to evaluate the validity of the STOP-Bang questionnaire to predict moderate-to-severe and severe OSA in the general population.
  
  
  
  A sample of 242 subjects selected from a population-based cohort in Singapore completed home-based sleep testing with a type 3 monitor. Subjects were asked to complete the STOP questionnaire while body mass index (BMI), age, neck circumference, and sex were recorded. A score of ≥3 on the questionnaire indicated high risk of OSA.
  
  
  
  A total of 68 subjects (28.1%) and 26 subjects (10.7%) had an apnea-hypopnea index (AHI) of ≥15 and ≥30 events per hour, respectively. Of the subjects, 89 (36.8%) were classified as high risk based on the questionnaire. The sensitivity of a STOP-Bang score of ≥3 was 66.2% to detect AHI ≥15 and 69.2% to detect AHI ≥30. The specificities were 74.7% and 67.1%, respectively. The negative predictive values were 85% for moderate-to-severe OSA and 94.8% for severe OSA. The corresponding positive predictive values were 50.6% and 20.2%, respectively. Using BMI cutoffs of 30 and 27.5 for Asians compared to the original cutoff of 35 did not improve the questionnaire performance significantly.
  
  
  
  The STOP-Bang questionnaire can be used as a screening tool in the general population in view of its moderate sensitivity and high negative predictive value for subjects with moderate-to-severe and severe OSA. The cutoff of BMI >35 can be used in Asians, as lower BMI cutoffs did not improve questionnaire performance.
authors.affiliation: Department of Respiratory Medicine, Ng Teng Fong General Hospital, Jurong Health Services, Singapore. Electronic address: ayytan@gmail.com.
authors.forename: Adeline
authors.initials: A
authors.lastname: Tan
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
authors.forename: Jason D C
authors.initials: JD
authors.lastname: Yin
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
authors.forename: Linda W L
authors.initials: LW
authors.lastname: Tan
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Dam
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre, Singapore.
authors.forename: Yan Yi
authors.initials: YY
authors.lastname: Cheung
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre, Singapore.
authors.forename: Chi-Hang
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009333:Neck / Q000473:pathology; D009929:Organ Size; D015995:Prevalence; D011379:Prognosis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D012846:Singapore; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D012913:Snoring / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Body mass index; General population; Obstructive sleep apnea; STOP-Bang; Screening