What is the Stop Bang (Sleep Apnea screening tool using Snoring, Tiredness, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, and Gender) score?

From the Guidelines

The STOP-BANG score is a useful screening tool for obstructive sleep apnea (OSA), but its low specificity limits its use in diagnosing individual patients, and it should be used in conjunction with other diagnostic tools, such as polysomnography, to confirm the diagnosis 1. The STOP-BANG questionnaire consists of eight yes/no questions, with each "yes" answer contributing one point to the total score. The acronym STOP-BANG stands for: Snoring, Tiredness/sleepiness during the day, Observed apnea, high blood Pressure, BMI over 35 kg/m², Age over 50, Neck circumference over 40 cm (16 inches), and male Gender. Some key points to consider when using the STOP-BANG score include:

• A score of 0-2 indicates low risk for OSA, 3-4 suggests intermediate risk, and 5-8 indicates high risk.
• The effectiveness of the STOP-BANG questionnaire comes from its simplicity and high sensitivity, especially at higher scores.
• Patients with high scores should be considered for further sleep evaluation, such as polysomnography, to confirm the diagnosis and determine appropriate treatment, which might include continuous positive airway pressure (CPAP) therapy, lifestyle modifications, or other interventions depending on OSA severity.
• The STOP-BANG score has been evaluated in several studies, including one published in the Journal of Clinical Sleep Medicine in 2017, which found that the questionnaire had high sensitivity but low specificity for the detection of OSA 1.
• Another study published in the Annals of Internal Medicine in 2014 reported low diagnostic accuracy of the STOP-BANG compared with a sleep study, with area under the curve (AUC) values ranging from 0.49 to 0.77 1.

From the Research

Overview of the STOP-Bang Score

• The STOP-Bang questionnaire is a validated screening tool for obstructive sleep apnea (OSA) 2, 3, 4, 5, 6
• It consists of eight dichotomous (yes/no) items related to the clinical features of sleep apnea, with a total score ranging from 0 to 8 3
• The questionnaire is used to classify patients for OSA risk based on their respective scores 3

Performance of the STOP-Bang Score

• The sensitivity of a STOP-Bang score ≥ 3 to detect moderate to severe OSA is high, ranging from 66.2% to 93% 2, 3, 5
• The negative predictive values for moderate to severe OSA and severe OSA are also high, ranging from 77% to 94.8% 2, 3, 4, 5
• The probability of moderate to severe OSA and severe OSA increases with higher STOP-Bang scores 2, 3

Use of the STOP-Bang Score in Different Populations

• The STOP-Bang questionnaire can be used as a screening tool in various populations, including sleep clinic populations, surgical populations, and the general population 2, 3, 4, 5, 6
• The questionnaire has been validated in different geographic regions, including North America, South America, Europe, Middle East, East Asia, and South or Southeast Asia 4
• The performance of the STOP-Bang score may vary slightly in different populations, but it remains a useful tool for screening for OSA 2, 3, 4, 5, 6

Combination with Other Screening Tools

• The STOP-Bang score can be used in combination with other screening tools, such as the Berlin questionnaire, American Society of Anesthesiologists (ASA) checklist, and Preoperative Sleep Apnea Prediction (PSAP) score, to improve its sensitivity 6
• The combination of the STOP-Bang score with the PSAP score has been shown to be a sensitive and convenient choice for detecting OSAHS in surgical patients 6