An effective model for screening moderate-to-severe obstructive sleep apnea based on the STOP-BANG questionnaire

BACKGROUND: This study aimed to develop a more effective screening model for moderate-to-severe obstructive sleep apnea (OSA) based on the best tool among Epworth Sleepiness Scale (ESS), NoSAS score and STOP-BANG questionnaire (SBQ). METHODS: This study screened 2,031 consecutive subjects referred with suspected OSA from 2012 to 2016, including the test cohort from 2012 to 2014 and the validation cohort from 2014 to 2016. Anthropometric measurements, polysomnographic data, ESS, NoSAS scores and SBQ scores were recorded. Receiver operating characteristic curve analyses were performed and the final predictive models were verified in a validation cohort. RESULTS: A total of 1,840 adults were finally included. The performance of ESS, NoSAS score and SBQ in screening OSA was compared. The diagnostic accuracy of SBQ was superior to ESS and NoSAS. A predictive model based on SBQ yielded an area under the curve (AUC) of 0.931 (95% CI: 0.915–0.946), and the sensitivity and specificity were 84.47 (95% CI: 81.4–87.2) and 87.36 (95% CI: 83.9–90.3) respectively. In the validation cohort, the AUC was 0.955 (95% CI: 0.938–0.969), with a sensitivity and specificity of 86.79 (95% CI: 83.2–89.9) and 90.88 (95% CI: 87.2–93.8) respectively. In addition, the model performed moderately in screening mild OSA with the AUC being 0.771 (95% CI: 0.721–0.815). CONCLUSIONS: The SBQ was effective in screening moderate-to-severe OSA. And a SBQ -based predictive model afforded excellent diagnostic efficacy, which could be applied in clinical practice.