Validity of Modified STOP-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea

Abstract

Objectives: The aim of this study was to evaluate the validity of a modified STOP-Bang questionnaire with different body mass index reference as a screening tool for obstructive sleep apnea in Korean population. Methods: The medical records of 1417 participants who underwent overnight Level I polysomnography were retrospectively analyzed. Predictive parameters were calculated for each of the 3 groups classified by obstructive sleep apnea severity with a cut-off value of 3 or 4. Responses to modified and traditional questionnaires were comparatively analyzed by receiver-operator characteristic curves and area under the receiver-operator characteristic curves. Results: The optimal cut-off values of the modified and traditional questionnaires were both 3.5. The area under the receiver-operator characteristic curve of modified STOP-Bang questionnaire for any obstructive sleep apnea group was 0.786 ± 0.018, which was significantly higher than that of the traditional questionnaire. The modified STOP-Bang questionnaire with a cut-off value ≥4 showed significantly higher sensitivity than the traditional one for any obstructive sleep apnea group. The diagnostic accuracy of the modified questionnaire was also significantly higher for the any obstructive sleep apnea group when the cut-off value was 4. Conclusion: The modified STOP-Bang questionnaire, with a cut-off value of 4, can be used as an alternative to the traditional screening tool for the Korean population.