Evaluation of a Modified STOP-BANG Questionnaire for Sleep Apnea in Adults from the Korean General Population

Abstract

Background and Objective There are few studies assessing diagnostic accuracy of the STOP-BANG questionnaire, which is a screening tool for detecting obstructive sleep apnea (OSA), in the general population. Our study aimed to develop a modified version of this screening questionnaire and compare its diagnostic accuracy to the standard version in general Korean adults. Methods A cross-sectional polysomnographic study was conducted among 2065 male and female participants aged 48–79 years, who were members of a population-based cohort study. Half of them were assigned to the exploratory sample and the other half to the validation sample. Results In this study, 958 individuals (487 in an exploratory sample) were identified to have OSA. To develop a model in an exploratory sample, stepwise analysis was used with information from the standard version and additional variables; snoring, witnessed breathing cessation, hypertension, body mass index > 25 kg/m2, age groups, male, diabetes, and waist circumference > 85 cm were included in a final modified model. In the evaluation of diagnostic accuracy in a validation sample, the modified model showed higher sensitivity [79.1%, 95% confidence interval (CI): 77.3, 80.9] in detecting severe OSA than that of the standard version model (66.0%, 95% CI: 64.0, 68.0). Overall accuracy indicated as area under the receiver-operating characteristic curve for the modified model was greater (p = 0.001) than that of the standard version model. Conclusions These findings suggest that the modified version of the STOP-BANG questionnaire may be useful in detecting severe OSA in general adults.

Keywords

• obstructive sleep apnea
• mass screening
• polysomnography