Comparison of Commonly Used Questionnaires to Identify Obstructive Sleep Apnea in a High-Risk Population
Open accessAbstract
Sleep apnea is associated with adverse health outcomes. Despite being an important comorbidity in obesity, type 2 diabetes, heart failure, and resistant hypertension, it is underdiagnosed in these patient groups. An inexpensive and readily accessible sleep apnea screening tool would help address this problem. We sought to compare three commonly used screening tools. We recruited 812 patients who had not previously been investigated for sleep apnea from our institution's diabetes (n = 512), obesity (n = 129), resistant hypertension (n = 74) and heart failure (n = 43) clinics. Patients completed three frequently used sleep apnea screening questionnaires (STOP-BANG, Berlin, and OSA50). A total of 758 patients had a valid (> 4 hours' duration) level 3 home sleep study. Studies were reported by a sleep physician and were deemed positive if they recorded a respiratory event index (REI) ≥ 15 events/h. The 758 patients with valid sleep studies were age 59 ± 11 years and 63% were male. A total of 38% of patients had a positive test. The respective sensitivities and specificities of the screening questionnaires at the recommended screening thresholds (REI ≥ 15 events/h) were STOP-BANG ≥ 3 (95% and 19%), STOP-BANG ≥ 5 (60% and 69%), Berlin (75% and 38%), and OSA50 (88% and 21%). We identified six independent predictors (age, sex, body mass index, neck circumference, snoring ≥ 3 days per week, observed apnea ≥ 3 days per week). However, combining these factors was no better than the STOP-BANG in predicting sleep apnea. All patients with a STOP-BANG < 3 had an REI < 30 events/h. There is a high prevalence of undiagnosed symptomatic sleep apnea in high-risk patient groups. The STOP-BANG questionnaire appeared superior, though all questionnaires had significant limitations. Incorporation of STOP-BANG ≥ 3 in this high-risk population might reduce the need for sleep testing in a resource-constrained setting. Kee K, Dixon J, Shaw J, Vulikh E, Schlaich M, Kaye DM, Zimmet P, Naughton MT. Comparison of commonly used questionnaires to identify obstructive sleep apnea in a high-risk population. J Clin Sleep Med. 2018;14(12):2057–2064.
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In a recent multicenter prospective study of 812 patients with type 2 diabetes, obesity, heart failure, or resistant hypertension, the STOP-BANG questionnaire with high-risk set to 3 points or above had greater sensitivity than the Berlin or OSA50 questionnaires (95%, 75%, and 88%, respectively).
“A recent multicenter prospective study enrolled 812 patients diagnosed with type 2 diabetes, obesity, HF, or resistant hypertension who completed multiple OSA screening questionnaires. Following a diagnostic sleep study, the STOP-BANG questionnaire (with “high-risk” set to 3 points or above) had a greater sensitivity than either the Berlin questionnaire or the OSA50 questionnaire (95%, 75%, and 88”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [455]
After increasing the STOP-BANG high-risk threshold to 5 or above, it had greater specificity (69%) than the Berlin (38%) or OSA50 (21%).
“After increasing the “high-risk” threshold to 5 or above on the STOP-BANG, it also had a greater specificity (69% compared to 38% for the Berlin and 21% for the OSA 50).”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [455]
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分割施工されるPC連続中空床版橋のひびわれに関する検討 : 宇都宮北道路上戸祭高架橋(仮称)4工区
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- Authors
- Kee, K., Dixon, J., Shaw, J., Vulikh, E., Schlaich, M., Kaye, D. M., Zimmet, P., & Naughton, M. T.
- Affiliations
- The Royal Melbourne Hospital (AU)
- Baker Heart and Diabetes Institute (AU)
- The Alfred Hospital (AU)
- Corresponding author
- Naughton, Matthew T.
- ORCID
- Venue
- Journal of Clinical Sleep Medicine
- Published
- 2018-12-15
- Volume
- 14
- Issue
- 12
- Pages
- 2057-2064
- ISSN
- 1550-9389 (ISSN-L)
- 1550-9397
- PMC
- PMC6287723
- OpenAlex
- W2905274345
- Semantic Scholar
- 53f8d971fb3c02fdf1fe59c89fa405bcbfafca0e
- Cited by
- 28
- References
- 32
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 6 · 2021: 8
- FWCI
- 1.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Sleep Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Monash University Research Portal (Monash University) (acceptedVersion, other-oa)
- UWA Profiles and Research Repository (University of Western Australia) (acceptedVersion, other-oa)
- UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- obstructive sleep apnea, STOP-BANG questionnaire, Berlin questionnaire, home sleep testing, respiratory event index, screening sensitivity and specificity, obesity, type 2 diabetes, resistant hypertension, heart failure, vulnerable populations, underdiagnosis
- MeSH terms
- Aged, Diabetes Mellitus, Type 2, Female, Heart Failure, Humans, Hypertension, Male, Mass Screening, Middle Aged, Obesity, Surveys and Questionnaires, Risk, Comorbidity, Polysomnography, Sleep Apnea, Obstructive
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