The STOP-BANG questionnaire: reliability and validity of the Persian version in sleep clinic population

Abstract

Purpose The snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck circumference, gender (STOP-BANG) is a concise and effective obstructive sleep apnea (OSA) screening tool, part questionnaire (STOP), and part demographic or anthropometric measurements (BANG). The main purpose of this study was to translate this well-liked questionnaire into Persian and assess its reliability and validity in sleep clinic population. Methods Standard forward–backward method was used for translation. A sample of 603 patients, who admitted to the sleep clinic, completely answered to the STOP questionnaire and underwent in-laboratory polysomnography, included in this study. Height, weight, and neck circumference were measured by technicians for calculating BANG score. The apnea–hypopnea index (AHI) on the polysomnography was used as gold standard for OSA diagnosis: none (AHI\5), mild (5 B AHI\15), moderate (15 B AHI\30), and severe (AHI C 30). One hundred and forty one patients were answered to the STOP questionnaire twice at a time interval of 2–4 weeks for test–retest analysis. Results In reliability analysis, 124 (87.9 %) patients had same STOP score and 130 (92.2 %) patients were classified in same risk of OSA. Based on the polysomnography, 438 patients (72.6 %) had mild (n = 124, 20.4 %), moderate (n = 114, 18.9 %), and severe (n = 201, 33.3 %) OSA, whereas according to the STOP-BANG, 502 patients (83.3 %) were at high risk of OSA. The sensitivity and specificity of the STOP-BANG were found to be 91.6 and 45.2 %, respectively, at AHI C 5, 97.1 and 35.2 %, respectively, at AHI C 15, and 98 and 29.4 %, respectively, at AHI C 30. The area under the curve of the STOPBANG for identifying mild, moderate, and severe OSA was 0.805, 0.779, and 0.755, respectively. Conclusions Persian version of the STOP-BANG performs similar to its original version and is an easy-to-use questionnaire which could be considered as a reliable and valid tool for OSA screening. Keywords STOP-BANG Obstructive sleep apnea Reliability Validity Polysomnography Persian