Sleep Related Questionnaires

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Stop, Stop Bang

Name of questionnaire

STOP Bang

Type of original questionnaire-description, age/population

The STOP questionnaire and subsequently expanded STOP-Bang questionnaire were developed to assess risk of underlying OSA in surgical patients. Developed as a concise and easy to use screening tool to identify patients with a high risk of underlying moderate to severe OSA.

Number of items

8 (snoring, tiredness, observed apnea, hypertension, BMI > 35 kg/m2, age > 50 years, neck circumference ≥ 16 inches, and male gender)

Number of domains & categories

Not applicable

Name of categories/domains

Not applicable

Scaling of items

Yes/No - each yes scored as 1 point

Scoring available: with permission or free

With permission from developer

Scoring test-retest reliability

Yes, Kappa coefficient 0.923 (CI 0.82-1.0)

Scoring Internal consistency

Yes

Validity

Internal validity of questionnaire confirmed using polysomnography (PSG) as reference test.

External validity measures adequately met.

Language

English

Translations in other languages (if yes, then list the languages)

French, Spanish, Afrikaans, Bulgarian, Chinese, Czech, Dutch, Finnish, German, Hungarian, Icelandic, Italian, Korean, Malay, Polish, Portuguese, Romanian, Serbian, Swedish, Taiwanese, Turkish, Urdu

Developer(s) name

Frances Chung MBBS, FRCPC

Developer contact information for permission

University of Toronto
Toronto Western Hospital
University Health Network
McL 2-405, 399 Bathurst Street, Toronto, On, Canada M5T 2S8
Ph:    416 603 5880 ext 5433
Fax:  416 603 6494
Email: Frances.Chung@uhn.ca

Availability of questionnaire: needs permission from developer, cost or freely available

Needs permission from developer

http://www.stopbang.ca/about/contactus.php

Limitations

 Heterogeneity of various populations with varying prevalence should be considered when interpreting results.

Link to website with general information

Link to questionnaire, if available

http://www.stopbang.ca/

http://www.stopbang.ca/osa/screening.php

Other comments

High sensitivity (93%-100%) noted when using STOP-Bang questionnaire to detect moderate to severe and severe sleep disordered breathing in surgical population patients however low specificity noted at original cut-off of 3.

Recent studies indicate total scores of 5-8 have higher specificity.

Validated patient populations

Wide variety of adult populations including medical, surgical, and dental patients, pregnant women, commercial drivers.

References (including original publication)
  1. Chung, F., Yegneswaran, B., Liao, P., Chung, S. A., Vairavanathan, S., Islam, S., Khajehdehi, A., and Shapiro, C. M. STOP Questionnaire: A Tool to Screen Obstructive Sleep Apnea. Anesthesiology 108, 812-821. 2008. 
  2. Chung F, Subramanyam R, Liao P, Sasaki E, Shapiro C, Sun Y. High STOP-Bang score indicates a high probability of obstructive sleep apnoea. Br J Anaesth. 2012 May;108(5):768-75.
  3. Abrishami A, Khajehdehi A, Chung F: A systematic review of screening questionnaires for obstructive sleep apnea. Can J Anesth 2010; 57:423-38. 
  4. Nagappa M, Liao P, Wong J, Auckley D, Ramachandran SK, Memtsoudis S, Mokhlesi B, Chung F. Validation of the STOP-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea among Different Populations: A Systematic Review and Meta-Analysis. PLoS One. 2015 Dec 14;10(12):e0143697.
  5. Pivetta B, Chen L, Nagappa M, Saripella A, Waseem R, Englesakis M, Chung F. Use and Performance of the STOP-Bang Questionnaire for Obstructive Sleep Apnea Screening Across Geographic Regions: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2021 Mar 1;4(3):e211009.
  6. Hwang M, Zhang K, Nagappa M, Saripella A, Englesakis M, Chung F. Validation of the STOP-Bang questionnaire as a screening tool for obstructive sleep apnoea in patients with cardiovascular risk factors: a systematic review and meta-analysis. BMJ Open Respir Res. 2021 Mar;8(1):e000848.
  7. ​​Lonia L, Scalese M, Rossato G, Bruno G, Zalunardo F, De Stefani A, Gracco A. Validity of the STOP-Bang Questionnaire in Identifying OSA in a Dental Patient Cohort. Medicina (Kaunas). 2020 Jun 30;56(7):324.
  8. Pearson F, Batterham AM, Cope S. The STOP-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea in Pregnancy. J Clin Sleep Med. 2019 May 15;15(5):705-710.

Updated by

Ashesha Mechineni, MD

The last date of update

November 2022