From the Guidelines
A STOP-BANG score of 5 is a strong indicator of high risk for obstructive sleep apnea (OSA) and necessitates immediate medical attention to prevent increased morbidity, mortality, and decreased quality of life. According to the clinical practice guideline for diagnostic testing for adult obstructive sleep apnea by the American Academy of Sleep Medicine 1, the STOP-BANG questionnaire has a sensitivity of 0.90 to 0.95, but specificity was 0.36, indicating a need for further diagnostic testing to confirm the diagnosis.
Key points to consider:
- The STOP-BANG questionnaire evaluates eight risk factors: Snoring, Tiredness, Observed apneas, high blood Pressure, BMI over 35, Age over 50, Neck circumference over 40cm, and male Gender.
- A score of 5 means you have five of these risk factors present, which correlates with approximately a 50-75% probability of moderate to severe OSA, as supported by the study 1.
- Untreated OSA increases risks for cardiovascular problems, metabolic disorders, and accidents due to daytime sleepiness, making timely diagnosis and treatment essential for your health.
I recommend scheduling an appointment with a sleep specialist for a formal sleep study, preferably a polysomnography, as suggested by the guideline 1. While waiting for the appointment, try sleeping on your side rather than your back, avoid alcohol and sedatives before bedtime, and maintain a healthy weight through diet and exercise if applicable. If you're experiencing excessive daytime sleepiness, use caution when driving or operating machinery.
From the Research
STOP-Bang Questionnaire
- The STOP-Bang questionnaire is a screening tool used to identify patients at high-risk of obstructive sleep apnea (OSA) 2
- It has various practical applications in anesthesia, surgery, and perioperative medicine 2
- Patients with a STOP-Bang score of 0--2 can be classified as low-risk for moderate-to-severe OSA, while those with a score of 5--8 can be classified as high-risk 2
Risk Stratification
- STOP-Bang can be used as a novel tool for perioperative risk stratification to identify patients at increased risk of perioperative complications 2
- A STOP-Bang score of at least 3 can be used to identify patients at high risk of moderate-to-severe OSA 2
- Further stratification can be done using a combination of STOP score, BMI, gender, and neck circumference to identify patients at higher risk of moderate-to-severe OSA 2
Clinical Applications
- The STOP-Bang questionnaire has been validated for use in the sleep clinic, surgical, and general population 2
- It can be used to reduce the false positive cases and improve its specificity in identifying patients at high risk of moderate-to-severe OSA 2
- STOP-Bang is a useful screening tool for patients with suspected or undiagnosed OSA, and can be used in conjunction with other clinical assessments to guide perioperative management 2