STOP-BANG: a method to detect obstructive sleep apnea and discriminate for severity in primary care

Introduction: A STOP-BANG questionnaire (SBQ) score of ≥3 may detect obstructive sleep apnea (OSA) but is not well studied in primary care (PC) Aims and Objectives: Assess the ability of SBQ to predict OSA severity in PC Methods: 30 to 70 year-olds attending any of 4 PC centres in a 22-month period were randomly selected. PC physician did the SBQ. A home respiratory polygraphy (HRP) was done when scores of ≥3 were found and an attended polysomnography (PSG) when apnea-hypopnea index (AHI) was Results: Of included patients (565), 38.2% had SBQ≥3. Of these, 93.1% were diagnosed with OSA (Figure 1). All cases with SBQ≥6 had an AHI≥5/h. SBQ discriminated patients with severe OSA (AHI≥30/h)(n=70, AUC=0.697, 95% CI:0.621-0.773): moderate in women (n=23, AUC=0.733, 95% CI:0.605-0.860) and lower in men (n=47, AUC=0.679, 95% CI:0.583-0.766). In these cases, SBQ≥5 in women had a sensitivity (Sn) of 52.2%, specificity (Sp) of 85.7%, positive likelihood ratio (LR+) of 3.65 and negative likelihood ratio (LR-) of 0.56; and SBQ≥6 in men gave Sn of 44.7%, Sp of 86.7%, LH+ of 3.35 and LH- of 0.64 Conclusions: SB≥3 may adequately screen for OSA in PC. Scores of SB≥5 in women and ≥6 in men could be good opportunistic predictors of severe OSA in PC.