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Evaluation of the Arabic version of STOP-Bang questionnaire as a screening tool for obstructive sleep apnea

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Abstract

Purpose

Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is underdiagnosed. OSA is usually diagnosed by polysomnography (PSG) and, if untreated, could lead to life-threatening complications. Many screening questionnaires have been developed to screen and identify patients at high risk for OSA. This study aimed to evaluate and validate the Arabic version of Stop-Bang questionnaire as a screening tool for patients with OSA symptoms referred to a sleep clinic.

Methods

All referred Arabic-speaking adult patients presenting to a Sleep Disorders Specialized Clinic in Al Ain for PSG were requested to complete an Arabic STOP-Bang questionnaire. A score of 3 or more out of a possible 8 was taken to indicate high risk for presence of OSA. These scores were then evaluated versus results from the overnight, monitored PSG. Apnea/hypopnea index (AHI) of ≥5/h was considered for diagnosis of OSA.

Results

One hundred ninety-three sleep clinic patients were enrolled in this study. PSG was positive (AHI ≥5) in 85 % of the studied population. STOP-Bang questionnaire was positive (≥3) in 87 % of the population. Reproducibility of STOP-Bang questionnaire was tested, and the intraclass correlation coefficient of the total score of STOP-Bang questionnaire was 0.931 (95 % CI 0.834–0.972). The sensitivities of the STOP-Bang screening tool for an AHI of ≥5, ≥15, and ≥30 were 90, 96.75, and 99.70 %, respectively, with negative predictive values (NPVs) of 36, 84, and 92 %, respectively. ROC curve was 0.77.

Conclusion

The Arabic version of STOP-Bang questionnaire is an easy-to-use tool that can be implemented as a reliable, quick screening tool for OSA in patients referred to sleep clinic. It demonstrated high sensitivity and NPV especially for patients with moderate to severe OSA. We believe that this tool will help physicians to earlier identify cases at risk of OSA.

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Abbreviations

OSA:

Obstructive sleep apnea

PSG:

Polysomnography

SB:

Stop-Bang

ESS:

Epworth sleepiness scale

AHI:

Apneas/hypopnea index

NPV:

Negative predictive values

PPV:

Positive predictive values

CI:

Confidence interval

ROC:

Receiver operating characteristic

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Acknowledgments

The authors thank Prof. Nico Nagelkerke for his help in the statistical analysis, Prof. Margaret Ann Elzubeir for language editing the manuscript, and Dr. Sarah Elzubeir for her help in the literature review.

Conflict of interest

The authors declare they have no conflict of interest

Authors’ contributions

S. Alhouqani contributed to the design of the study, data collection, and writing the manuscript. M. Al Manhali contributed to the design of the study, data collection, and writing the manuscript. A. Al Essa contributed to data analysis. M. Al-Houqani contributed to the design of the study, data collection, data analysis, and writing the manuscript.

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Authors and Affiliations

  1. Tawam Hospital, Abu Dhabi, United Arab Emirates

    Shaikha Alhouqani

  2. Ambulatory Health Services, Abu Dhabi, United Arab Emirates

    Mariam Al Manhali

  3. Nursing Research, Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Abu Dhabi, United Arab Emirates

    Awad Al Essa

  4. College of Medicine and Health Sciences, UAE University, P.O.Box 17666, Al Ain, Abu Dhabi, United Arab Emirates

    Mohammed Al-Houqani

Authors
  1. Shaikha Alhouqani
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  2. Mariam Al Manhali
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  3. Awad Al Essa
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  4. Mohammed Al-Houqani
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Correspondence to Mohammed Al-Houqani.

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Alhouqani, S., Al Manhali, M., Al Essa, A. et al. Evaluation of the Arabic version of STOP-Bang questionnaire as a screening tool for obstructive sleep apnea. Sleep Breath 19, 1235–1240 (2015). https://doi.org/10.1007/s11325-015-1150-x

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  • DOI: https://doi.org/10.1007/s11325-015-1150-x

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