Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Psychiatry, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
J Sleep Res. 2018 Dec;27(6):e12702. doi: 10.1111/jsr.12702. Epub 2018 Apr 22.
Obstructive sleep apnea (OSA) is a sleep disorder associated with significant cardiovascular comorbidities, including cardiac arrhythmia. The STOP-BANG questionnaire is an eight-item self-report questionnaire designed to screen patients for OSA and was validated in preoperative surgical patients. The STOP items are snoring, daytime tiredness, observed apneas and high blood pressure. The BANG items are body mass index >35 kg/m , age >50 years, neck circumference >40 cm and male gender. We aimed to determine the screening properties of the STOP-BANG questionnaire in patients with arrhythmia. Non-selected consecutive patients were recruited from arrhythmia clinics. Patients with previously diagnosed and/or treated OSA were excluded. The STOP-BANG questionnaire was self-administered. Patients underwent two consecutive nights of home sleep recording. OSA was defined as an apnea-hypopnea index score of ≥5/hr of sleep. The screening properties of the STOP-BANG questionnaire were analysed compared with the objective diagnosis of OSA by ambulatory testing. Ninety-five patients were included in the final analysis. Eighty-five percent were found to have OSA. The STOP-BANG score of ≥3 was 89% sensitive and 36% specific for diagnosis of OSA. The STOP-BANG questionnaire had fair performance, as indicated by an area under the curve of 0.74 (p = .004). In conclusion, the STOP-BANG questionnaire is sensitive; however, it has a low specificity with a high false positive rate. Given that a large number of atrial fibrillation patients need testing for OSA, we recommend the use of a level II sleep study regardless of the results of the screening questionnaire. This approach accurately identifies OSA and may limit the cost of unnecessary level-I sleep studies.
阻塞性睡眠呼吸暂停（OSA）是一种与重大心血管合并症相关的睡眠障碍，包括心律失常。STOP-BANG 问卷是一种八项自评问卷，用于筛查 OSA，已在术前手术患者中得到验证。STOP 项目包括打鼾、白天疲劳、观察到的呼吸暂停和高血压。BANG 项目包括体重指数（BMI）>35kg/m2、年龄>50 岁、颈围>40cm 和男性。我们旨在确定 STOP-BANG 问卷在心律失常患者中的筛查特性。从心律失常诊所招募了非选择性连续患者。排除了先前诊断和/或治疗过 OSA 的患者。STOP-BANG 问卷由患者自行填写。患者接受了连续两晚的家庭睡眠记录。OSA 的定义为睡眠中每小时呼吸暂停-低通气指数评分≥5。通过动态监测分析 STOP-BANG 问卷与 OSA 的客观诊断的筛查特性。95 例患者纳入最终分析。85%的患者被发现患有 OSA。STOP-BANG 评分≥3 对 OSA 的诊断具有 89%的敏感性和 36%的特异性。STOP-BANG 问卷的表现中等，曲线下面积为 0.74（p=0.004）。总之，STOP-BANG 问卷具有较高的敏感性，但特异性低，假阳性率高。鉴于大量心房颤动患者需要进行 OSA 测试，我们建议无论筛查问卷的结果如何，都使用二级睡眠研究。这种方法可以准确识别 OSA，并可能限制不必要的一级睡眠研究的成本。
