Mergen Haluk, Altındağ Burak, Zeren Uçar Zeynep, Karasu Kılıçaslan Işıl
Family Medicine, University of Health Sciences, Izmir Tepecik Health Practice & Research Center, Izmir, TUR.
Sleep Medicine, University of Health Sciences, Izmir Dr. Suat Seren Health Practice & Research Center, Izmir, TUR.
Cureus. 2019 Dec 29;11(12):e6498. doi: 10.7759/cureus.6498.
Background The prevalence of obstructive sleep apnea (OSA) is high in the obese population. In this study, it was aimed to fulfill the STOP-Bang questionnaire which is a concise and easy-to-use questionnaire for OSA screening in obese patients. Materials & methods This is a retrospective study where the patients, who planned polysomnography, were referred to sleep clinic. Patients were screened for OSA by the STOP-Bang questionnaire. Laboratory polysomnography was performed in 275 patients. Patients with BMI ≥ 30 were taken into study. The screening test was evaluated by three different risk analysis such as, a STOP score, a STOP-Bang score and a modified STOP-Bang score. The predictive parameters (sensitivity, specificity, and positive and negative predictive values) for alternative scoring models in obese patients were analyzed. Results In 217 obese patients, a STOP score cutoff of 3 and a STOP-Bang score cutoff of 4 provides a better balance of sensitivity and specificity for all OSA (apnea-hypopnea index [AHI] ≥ 5). The STOP questionnaire revealed a sensitivity of 87.9% and a positive predictive value of 99.5% for patients with all OSA (p: 0.005). The STOP-Bang scoring model revealed a sensitivity of 95.3% and a positive predictive value of 99.5% for patients with all OSA (p < 0.001). The modified STOP-Bang scoring revealed a sensitivity of 95.8% and a positive predictive value of 99.5% for patients with all OSA (p < 0.001). The area under the curve of the STOP-Bang for identifying mild, moderate and severe OSA was 0.581, 0.652 and 0.675, respectively. Whereas according to the STOP-Bang, all morbid obese patients (obesity class III, n: 47) were at high risk of OSA. Conclusion This study suggests that the STOP-Bang questionnaire for obstructive sleep apnea screening in obese patients is a high sensitivity and appropriate screening test.
肥胖人群中阻塞性睡眠呼吸暂停（OSA）的患病率很高。本研究旨在完成STOP-Bang问卷，这是一种用于肥胖患者OSA筛查的简洁易用的问卷。
这是一项回顾性研究，计划进行多导睡眠图检查的患者被转诊至睡眠诊所。通过STOP-Bang问卷对患者进行OSA筛查。对275例患者进行了实验室多导睡眠图检查。纳入研究的患者BMI≥30。通过三种不同的风险分析评估筛查试验，即STOP评分、STOP-Bang评分和改良STOP-Bang评分。分析了肥胖患者替代评分模型的预测参数（敏感性、特异性以及阳性和阴性预测值）。
在217例肥胖患者中，STOP评分临界值为3且STOP-Bang评分临界值为4时，对所有OSA（呼吸暂停低通气指数[AHI]≥5）而言，敏感性和特异性的平衡更佳。STOP问卷显示，所有OSA患者的敏感性为87.9%，阳性预测值为99.5%（p：0.005）。STOP-Bang评分模型显示，所有OSA患者的敏感性为95.3%，阳性预测值为99.5%（p<0.001）。改良STOP-Bang评分显示，所有OSA患者的敏感性为95.8%，阳性预测值为99.5%（p<0.001）。用于识别轻度、中度和重度OSA的STOP-Bang曲线下面积分别为0.581、0.652和0.675。而根据STOP-Bang问卷，所有病态肥胖患者（III级肥胖，n：47）均处于OSA高风险。
本研究表明，用于肥胖患者阻塞性睡眠呼吸暂停筛查的STOP-Bang问卷是一种高敏感性且合适的筛查试验。
