stop-bang score as a guide for split-night polysomnography

Background and objective: stop-bang questionnaire is a well-known obstructive sleep apnea (osa) screening tool. this study aimed to evaluate that patients with high probability of osa in stop-bang questionnaire meet the criteria for assessment by split-night polysomnography (psg). materials and methods: patients who were admitted to three sleep clinics and underwent full-night psg entered into the study. the patients filled in the stop questionnaire at their first clinic visit. weight, height, and neck circum-ference were measured by technicians for computing stop-bang score. the apnea–hypopnea index (ahi) was used for diagnosis of osa for which 5 ≤ ahi < 15, 15 ≤ ahi < 30, and ahi ≥ 30 were considered as mild, moderate, and severe osa, respectively. ahi cutoff levels of 20 and 40 were used to evaluate split-night psg criteria. sensitivity analysis was performed for identifying predictive parameters. results: in assessment of 990 patients, the sensitivity of the stop-bang ≥ 3 for osa diagnosis at ahi thresholds of 5, 15 and 30 were 93, 96 and 97.8, and the specificity were 39, 24.5 and 20, respectively. the specificities of the stop-bang score ≥ 7 for osa diagnosis at ahi thresholds of 20 and 40 were 99.2 and 97.9, and the positive predic-tive values were 90.5 and 64.3, respectively. conclusion: we found that the stop-bang could be considered not only as an osa screening test, but also as a test to determine proper patients for split-night psg, the benefit of which is a cost reduction in osa management.