• Eduardo Borsini, Glenda Ernst, Alejandro Salvado, Martín Bosio, Julio Chertcoff, Facundo Nogueira, and Carlos Nigro.
• Hospital Británico de Buenos Aires, Buenos Aires, Argentina. borsinieduardo@yahoo.com.ar.
• Sleep Breath. 2015 Dec 1; 19 (4): 1327-33.

BackgroundUtility of questionnaires to estimate the probability of obstructive sleep apneas (OSA) is varying, and it is challenging to know the performance of STOP (Snore, Tired, Observed apnea, and Pressure)-BANG (BMI, Age, Neck and Gender) with simplified methods. To assess the performance of STOP-BANG and its ability to predict sleep apnea in patients with high pre-test like-hood to present OSA referred for a home respiratory polygraphy (RP) were studied.MethodA cross-sectional study of patients recruited over 26 months was performed. They were asked to complete the STOP-BANG questionnaire during evaluation prior to RP and were evaluated according to different apnea-hypopnea index (AHI) cut-offs. Areas under receiver operating characteristic (ROC) curves and multiple logistic regression models were calculated.ResultsEight hundred sixty-nine patients were studied; 557 were male (64.1 %) with a median age of 52.82 ± 14.43 years, a body mass index (BMI) of 32.88 ± 8.51, and Epworth Sleepiness Scale (ESS) score of 7.95 ± 5.17. The performance for AHI ≥5/h (ROC area) was: STOP 0.62, BANG 0.66, and STOP-BANG 0.69. The best sensitivity (S)-specificity (Sp) relationship for AHI ≥5/h was found with 5 components in any combination (S 56.02 %; Sp 70 %). For AHI ≥30/h, STOP was 0.68, BANG 0.66 and STOP-BANG 0.73 and the best S-Sp relationship was obtained with 5 components (S 68 %; Sp 63.6 %). Six variables (snoring, observed apneas, high blood pressure (HBP), BMI >35, neck perimeter >40 cm, and male gender) showed the best performance for AHI >30/h; ROC area 0.76.ConclusionSTOP-BANG shows different discrimination power for AHI >5 and ≥30/h using RP. Five components in any combination have acceptable diagnostic S to identify patients with severe OSA. STOP-BANG performed best to identify AHI ≥30/h.

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