Stop-Bang questionnaire in obstructive sleep apnea syndrome: A severity predictor

2015 
Introduction: Obstructive sleep apnea syndrome (OSAS) is a very prevalent entity; in order to standardise the clinical history, different questionnaires have been developed. The STOP- Bang (S-B) questionnaire has a 87% sensitivity to identify patients with a moderate to severe OSAS, who should be treated with CPAP. Our objetive was to validate the S- B questionnaire as a predictor of severity. Methods: Prospective study developed at the Respiratory department at the University Hospital Miguel Servet (Zaragoza, Spain) (January- April 2014). We included 152 patients sent for sleep study: 100 (65.8%) were men (mean age 53,53±13,21). They all underwent clinical history, physical examination and sleepiness questionnaires, Epworth and Stop- Bang. Diagnosis of OSAS included: home-based sleep study, and once these results were evaluated, the titration study with Automatic CPAP. Results: Descriptive data: AHI (26,14 ±20,70); Epworth (8,85 ± 4,20), BMI (30,31 ± 6,58). In our sample, moderate-severe OSAS was diagnosed in 100 patients (65%). The S-B questionnaire reached a Sensitivity (Se) of 96% , Specificity (S) of 40%, a positive predictive value (PPV) 71% and a negative predictive value (NPV) 76%. To diminish the subjectivity of this test, we applied the questionnaire so that a positive answer in the sleepiness item counted only when the Epworth test was 10. With this adjustment, we obtained a SE of 87%, S 50%, PPV 76% and NPV 66%. Conclusions: The S- B questionnaire can predict patients with a moderate- severe OSAS, who meet criteria for treatment with CPAP and have to be titrated. On the first consultation it allows to quickly plan the next visit to continue the diagnosis process without delay.
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