Department of Anaesthesia, Sunderland Royal Hospital, Kayll Rd, Sunderland, United Kingdom.
School of Health and Social Care, Teesside University, Middlesbrough, United Kingdom.
J Clin Sleep Med. 2019 May 15;15(5):705-710. doi: 10.5664/jcsm.7754.
We examined the validity of the STOP-Bang questionnaire and a modified STOP-Bang questionnaire to screen for obstructive sleep apnea (OSA) in women with obesity during the second trimester of pregnancy.
Ninety-nine pregnant women age 18 years or older with body mass index ≥ 40 kg/m completed the STOP-Bang questionnaire during their second trimester. The number of oxygen desaturation events (≥ 4% from baseline) was measured using overnight pulse oximetry, with OSA defined as ≥ 5 events/h. A Modified STOP-Bang score was derived by replacing the "Tired" item with Epworth Sleepiness Scale score ≥ 10. Seven candidate models were compared using information theoretic criteria: STOP-Bang, Modified STOP-Bang, and individual STOP-Bang items (Snore, Tired, Observed to stop breathing, high blood Pressure and Neck circumference). We used penalized logistic regression and negative binomial regression to derive predicted probabilities of having OSA and the predicted total event counts.
The predicted probability of meeting oximetry criteria for OSA increased with higher STOP-Bang scores, from < 10% for a score < 3 to 68% with a score of 6. The total number of disordered breathing events was 1.26 (95% confidence interval 1.06 to 1.50) times greater for a 1-unit increase in STOP-Bang. Of the candidate models, the best relative fit was the Snore item followed by STOP-Bang score (essentially equivalent). The predicted probability of having OSA was 5.0% for no snoring and 26.4% for snoring.
STOP-Bang has been shown to be a useful screening tool for OSA in pregnant women with obesity; however, the snoring question alone might be a simpler, effective predictor.
Registry: ClinicalTrials.gov; Title: STOPBANG As A Screening Tool for Obstructive Sleep Apnoea in Pregnancy; URL: https://clinicaltrials.gov/ct2/show/NCT02542488; Identifier: NCT02542488.
我们研究了阻塞性睡眠呼吸暂停（OSA）在妊娠中期肥胖女性中的 STOP-Bang 问卷和改良 STOP-Bang 问卷的有效性。
99 名年龄在 18 岁或以上、体重指数≥40kg/m2的孕妇在妊娠中期完成了 STOP-Bang 问卷。使用夜间脉搏血氧仪测量氧减事件（与基线相比≥4%）的次数，OSA 定义为≥5 次/h。改良 STOP-Bang 评分通过用 Epworth 嗜睡量表评分≥10 替代“疲倦”项来计算。使用信息理论标准比较了 7 个候选模型：STOP-Bang、改良 STOP-Bang 和单个 STOP-Bang 项目（打鼾、疲倦、观察到呼吸暂停、高血压和颈围）。我们使用惩罚逻辑回归和负二项回归得出 OSA 的预测概率和预测总事件数。
随着 STOP-Bang 评分的增加，符合血氧仪 OSA 标准的预测概率增加，评分<3 时<10%，评分 6 时为 68%。STOP-Bang 评分增加 1 分，呼吸紊乱事件总数增加 1.26 倍（95%置信区间 1.06-1.50）。在候选模型中，最好的相对拟合是打鼾项目，其次是 STOP-Bang 评分（基本相同）。无打鼾的 OSA 预测概率为 5.0%，打鼾的 OSA 预测概率为 26.4%。
STOP-Bang 已被证明是肥胖孕妇 OSA 的有用筛查工具；然而，仅打鼾问题可能是一种更简单、有效的预测指标。
注册处：ClinicalTrials.gov；标题：STOPBANG 作为妊娠阻塞性睡眠呼吸暂停的筛查工具；网址：https://clinicaltrials.gov/ct2/show/NCT02542488；标识符：NCT02542488。
