Assembly

Stop, Stop Bang

Name of questionnaire STOP Bang
Type of original questionnaire-description, age/population The STOP questionnaire and subsequently expanded STOP-Bang questionnaire were developed to assess risk of underlying OSA in surgical patients. Developed as a concise and easy to use screening tool to identify patients with a high risk of underlying moderate to severe OSA.
Number of items 8 (snoring, tiredness, observed apnea, hypertension, BMI > 35 kg/m2, age > 50 years, neck circumference ≥ 16 inches, and male gender)
Number of domains & categories Not applicable
Name of categories/domains Not applicable
Scaling of items Yes/No - each yes scored as 1 point
Scoring available: with permission or free With permission from developer
Scoring test-retest reliability Yes, Kappa coefficient 0.923 (CI 0.82-1.0)
Scoring Internal consistency Yes
Validity Internal validity of questionnaire confirmed using polysomnography (PSG) as reference test.

External validity measures adequately met.
Language English
Translations in other languages (if yes, then list the languages) French, Spanish, Afrikaans, Bulgarian, Chinese, Czech, Dutch, Finnish, German, Hungarian, Icelandic, Italian, Korean, Malay, Polish, Portuguese, Romanian, Serbian, Swedish, Taiwanese, Turkish, Urdu
Developer(s) name Frances Chung MBBS, FRCPC
Developer contact information for permission University of Toronto
Toronto Western Hospital
University Health Network
McL 2-405, 399 Bathurst Street, Toronto, On, Canada M5T 2S8
Ph: 416 603 5880 ext 5433
Fax: 416 603 6494
Email: Frances.Chung@uhn.ca
Availability of questionnaire: needs permission from developer, cost or freely available Needs permission from developer

http://www.stopbang.ca/about/contactus.php
Limitations Heterogeneity of various populations with varying prevalence should be considered when interpreting results.
Link to website with general information

Link to questionnaire, if available

 http://www.stopbang.ca/

http://www.stopbang.ca/osa/screening.php
Other comments High sensitivity (93%-100%) noted when using STOP-Bang questionnaire to detect moderate to severe and severe sleep disordered breathing in surgical population patients however low specificity noted at original cut-off of 3.

Recent studies indicate total scores of 5-8 have higher specificity.
Validated patient populations Wide variety of adult populations including medical, surgical, and dental patients, pregnant women, commercial drivers.
References (including original publication)
  1. Chung, F., Yegneswaran, B., Liao, P., Chung, S. A., Vairavanathan, S., Islam, S., Khajehdehi, A., and Shapiro, C. M. STOP Questionnaire: A Tool to Screen Obstructive Sleep Apnea. Anesthesiology 108, 812-821. 2008.
  2. Chung F, Subramanyam R, Liao P, Sasaki E, Shapiro C, Sun Y. High STOP-Bang score indicates a high probability of obstructive sleep apnoea. Br J Anaesth. 2012 May;108(5):768-75.
  3. Abrishami A, Khajehdehi A, Chung F: A systematic review of screening questionnaires for obstructive sleep apnea. Can J Anesth 2010; 57:423-38.
  4. Nagappa M, Liao P, Wong J, Auckley D, Ramachandran SK, Memtsoudis S, Mokhlesi B, Chung F. Validation of the STOP-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea among Different Populations: A Systematic Review and Meta-Analysis. PLoS One. 2015 Dec 14;10(12):e0143697.
  5. Pivetta B, Chen L, Nagappa M, Saripella A, Waseem R, Englesakis M, Chung F. Use and Performance of the STOP-Bang Questionnaire for Obstructive Sleep Apnea Screening Across Geographic Regions: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2021 Mar 1;4(3):e211009.
  6. Hwang M, Zhang K, Nagappa M, Saripella A, Englesakis M, Chung F. Validation of the STOP-Bang questionnaire as a screening tool for obstructive sleep apnoea in patients with cardiovascular risk factors: a systematic review and meta-analysis. BMJ Open Respir Res. 2021 Mar;8(1):e000848.
  7. Lonia L, Scalese M, Rossato G, Bruno G, Zalunardo F, De Stefani A, Gracco A. Validity of the STOP-Bang Questionnaire in Identifying OSA in a Dental Patient Cohort. Medicina (Kaunas). 2020 Jun 30;56(7):324.
  8. Pearson F, Batterham AM, Cope S. The STOP-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea in Pregnancy. J Clin Sleep Med. 2019 May 15;15(5):705-710.
Updated by Ashesha Mechineni, MD
The last date of update November 2022