Evaluation of five different questionnaires for assessing sleep apnea syndrome in a sleep clinic

Abstract

BackgroundObstructive sleep apnea/hypopnea syndrome (OSAHS) is a major cause of morbidity and mortality. Different clinical models and questionnaires have been used to evaluate patients with the highest OSAHS probability. ObjectivesTo evaluate the clinical utility of five different questionnaires – STOP, STOPBang (SB), Berlin Questionnaire (BQ), Epworth Sleepiness Scale (ESS), and 4-Variable Screening Tool (4-V) – in a sleep clinic in order to identify patients at risk for OSAHS and to assess the best possible combination of these tools. Methods1853 (74.4% males) patients (mean age 52±14years; mean body mass index 32.8±7kg/m2) visiting a sleep clinic were studied retrospectively. ResultsSB had the highest sensitivity (97.6%), the largest area under the receiver operating characteristics curve (AUC) (0.73; 95% CI, 0.7–0.76) and best OR (5.9; 95% CI, 3.6–9.5), but the lowest specificity (12.7%) for AHI ⩾15. The 4-V ⩾14 had the highest specificity (74.4%) followed by ESS (67%). BQ had good sensitivity (87%), worse specificity (33%) than 4-V and ESS but better than STOP (13%) and SB (12.7%). The combination of questionnaires did not improve their predictive value. ConclusionsSB had the highest sensitivity, OR, and AUC, but rather low specificity, and 4-V the highest specificity. The combination of different questionnaires did not improve their predictive value.