Neuropsychological functioning of nonapneic snoring Hong Kong Chinese

Abstract

Introduction: The STOP-bang questionnaire has been well validated as a screening tool for obstructive sleep apnea (OSA) in general surgery patients, but not in bariatric surgery (BS) patients. In our previous study, the STOP-bang score of ≥ 3 showed a high sensitivity (96%), but low specificity (20%) in BS patients. We hypothesize that a higher score is needed to diagnose OSA in BS patients. Methods: This is a retrospective study of consecutive subjects who had a sleep study prior to BS. All subjects answered the STOP-bang questionnaire prior to their sleep study. Subjects currently treated with positive airway pressure therapy were excluded. The sensitivity, specificity, and likelihood ratio for STOP-bang scores of 4 to 7 were calculated. Results: A total of 59 patients were included in the study. The prevalence of OSA in the BS population was 84%. The sensitivity/specificity for STOP-bang scores of ≥4 along with AHI>5, AHI>15 and AHI>30 was 82/60%, 85/40%, and 90/34%, respectively. The sensitivity/specificity of STOP-bang score of ≥5 for AHI>5, AHI>15 and AHI>30 was 59/90%, 68/72%, and 76/63%, respectively. The sensitivity/specificity of STOP-bang score of ≥6 for AHI>5, AHI>15 and AHI>30 was 33/100%, 41/92%, and 52/87%, respectively. The sensitivity of STOP-bang score of ≥7 for AHI>5, AHI>15 and AHI>30 was 14/100%, 21/100%, and 33/100%, respectively. The OSA likelihood ratio (LR) for STOP-bang scores of 4 or 5 with an AHI>5 were 2.05 and 5.9, respectively, whereas for scores ≥6 the LRs were infinite. All patients with a STOP-bang score ≥6 had OSA, and all patients with STOP-bang scores ≥7 had severe OSA. Conclusion: Higher STOP-Bang score cut-off values progressively improved their predictive power of detecting OSA in BS patients. A STOPbang score ≥5 in BS patients is associated with OSA with a post-test probability of 97%.