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Background and ObjectiveaaThe conventional criteria for body-mass index (BMI > 35 kg/m2) and neck circumference (NC > 40 cm) in the snoring, tiredness, observed apnea, high blood pressure, BMI, age, NC, and gender (STOP-Bang) Questionnaire may be too high to screen Korean obstructive sleep apnea (OSA) patients properly. We hypothesized that using a modified STOP-Bang Questionnaire with lower BMI and NC criteria may be more appropriate when screening South Korean patients with OSA. We aimed to evaluate the utility of the modified STOP-Bang Questionnaires and to compare it with that of conventional STOP or STOP-Bang Questionnaire. MethodsaaThis was a cross-sectional single-center study done at Kyung Hee University Hospital at Gangdong. Consecutive patients who underwent polysomnography and had done the STOPBang Questionnaire between November 2010 and December 2017 were reviewed. We used alternative cut-off criteria for BMI as 30 kg/m2 and for NC as 36.3 cm. ResultsaaA total of 778 patients was evaluated; 73.1% of them had some OSA [apnea-hypopnea index (AHI) > 5/hr] and 54.5% had moderate to severe OSA (AHI > 15/hr). The area under the curve (AUC) of the modified STOP-Bang was slightly larger than for the conventional STOP-Bang or STOP for having any OSA (AUC 0.787, 0.781, and 0.765, respectively) or for moderate to severe OSA (AUC 0.749, 0.747, and 0.721). The conventional STOP-Bang Questionnaire with a cut-off score of 3 identified all OSA and moderate to severe OSA patients with a sensitivity of 94.7% and 96.9%, respectively. The modified STOP-Bang showed improved sensitivity for any or moderate to severe OSA of 95.6% and 98.1%, respectively, with a decrease in exchange for lower specificity. ConclusionsaaBecause of the high prevalence of undiagnosed OSA, the modified STOP-Bang might be more appropriate in screening South Korean patients with OSA. Sleep Med Res 2020;11(1):38-43

sleep medicine research

Usefulness of Using Alternative Body-Mass Index and Neck Circumference Criteria for STOP-Bang Questionnaire in Screening South Korean Obstructive Sleep Apnea Patients