Usefulness of Using Alternative Body-Mass Index and Neck Circumference Criteria for STOP-Bang Questionnaire in Screening South Korean Obstructive Sleep Apnea Patients
Jung‐Ick Byun, Dongha Kim, Jeong‐Su Kim, Won Chul Shin
Abstract
Background and ObjectiveaaThe conventional criteria for body-mass index (BMI > 35 kg/m 2 ) and neck circumference (NC > 40 cm) in the snoring, tiredness, observed apnea, high blood pressure, BMI, age, NC, and gender (STOP-Bang) Questionnaire may be too high to screen Korean obstructive sleep apnea (OSA) patients properly. We hypothesized that using a modified STOP-Bang Questionnaire with lower BMI and NC criteria may be more appropriate when screening South Korean patients with OSA. We aimed to evaluate the utility of the modified STOP-Bang Questionnaires and to compare it with that of conventional STOP or STOP-Bang Questionnaire. MethodsaaThis was a cross-sectional single-center study done at Kyung Hee University Hospital at Gangdong. Consecutive patients who underwent polysomnography and had done the STOP-Bang Questionnaire between November 2010 and December 2017 were reviewed. We used alternative cut-off criteria for BMI as 30 kg/m 2 and for NC as 36.3 cm. ResultsaaA total of 778 patients was evaluated; 73.1% of them had some OSA [apnea-hypopnea index (AHI) > 5/hr] and 54.5% had moderate to severe OSA (AHI > 15/hr). The area under the curve (AUC) of the modified STOP-Bang was slightly larger than for the conventional STOP-Bang or STOP for having any OSA (AUC 0.787, 0.781, and 0.765, respectively) or for moderate to severe OSA (AUC 0.749, 0.747, and 0.721). The conventional STOP-Bang Questionnaire with a cut-off score of 3 identified all OSA and moderate to severe OSA patients with a sensitivity of 94.7% and 96.9%, respectively. The modified STOP-Bang showed improved sensitivity for any or moderate to severe OSA of 95.6% and 98.1%, respectively, with a decrease in exchange for lower specificity. ConclusionsaaBecause of the high prevalence of undiagnosed OSA, the modified STOP-Bang might be more appropriate in screening South Korean patients with OSA.