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Screening for obstructive sleep apnoea using the STOPBANG questionnaire

Aj Larner and Ziso B
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DOI: https://doi.org/10.7861/clinmedicine.18-1-108a
Clin Med February 2018
Aj Larner
Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom
Roles: Consultant neurologist
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Ziso B
Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom
Roles: Consultant neurologist
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Editor – We read with interest the report by Isaac et al.1 in which they screened for obstructive sleep apnoea (OSA) in acute medical take patients, in particular their use of the STOPBANG questionnaire.2 We also have experience using this instrument, in the context of a cognitive disorders clinic based in a neurology centre,3 because of the possible contribution of OSA to symptoms of cognitive impairment.4

Our cohort of consecutive patients referred over a 3-month period with unexplained memory symptoms (n=67) was somewhat younger than that of Isaac et al (≤50 years of age: 12/67 = 18% vs 31/93 = 33%) and with a male preponderance (61% vs 43%). Nevertheless, using the STOPBANG score ≥3/8, the criterion for ‘suspected high risk of OSA’, around half of our patients screened positive (33/67 = 49% vs 73% in Isaac et al).

Evidently, STOPBANG is a highly sensitive test and therefore likely to detect prevalent cases of OSA, but in addition it will also identify large numbers of false positives; examination of the item content of STOPBANG shows that any tired male over 50 years of age will screen positive, ie score ≥3/8. Hence, as a stand-alone screen on which to base decisions about onward referral to services dedicated to diagnosis and treatment of OSA, use of STOPBANG might well prove overwhelming.3 We therefore endorse the idea of using a second screener, such as the Epworth sleepiness score (ESS), prior to initiating onward referral to OSA services in order to try to reduce the false positive rate.

  • © Royal College of Physicians 2018. All rights reserved.

References

  1. ↵
    1. Isaac BTJ
    , Clarke SE, Islam MS, Samuel JT. Screening for obstructive sleep apnoea using the STOPBANG questionnaire and the Epworth sleepiness score in patients admitted on the unselected acute medical take in a UK hospital. Clin Med 2017;17:499–503.
    OpenUrlAbstract/FREE Full Text
  2. ↵
    1. Chung F
    , Yegneswaran B, Liao P, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology 2008;108:812–21.
    OpenUrlCrossRefPubMed
  3. ↵
    1. Ziso B
    , Larner AJ. STOP-Bang: screening for obstructive sleep apnoea in a cognitive disorders clinic. J Sleep Disord Ther 2016;5:223.
    OpenUrl
  4. ↵
    1. Shastri A
    , Bangar S, Holmes J. Obstructive sleep apnoea and dementia: is there a link? Int J Geriatr Psychiatry 2016;31:400–5.
    OpenUrl
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Screening for obstructive sleep apnoea using the STOPBANG questionnaire
Aj Larner, Ziso B
Clinical Medicine Feb 2018, 18 (1) 108-109; DOI: 10.7861/clinmedicine.18-1-108a

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Screening for obstructive sleep apnoea using the STOPBANG questionnaire
Aj Larner, Ziso B
Clinical Medicine Feb 2018, 18 (1) 108-109; DOI: 10.7861/clinmedicine.18-1-108a
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