Validation of the STOP, STOP-BANG Questionnaire and Its Modifications for Screening Obstructive Sleep Apnea in Southern Thailand

Sakarin Tangpothitham; Premthip Chalidapongse; Nattapon Rotpenpian; Noodchanath Kongchouy; Pankaew Yakkaphan

doi:10.31584/jhsmr.20261358

Authors

Sakarin Tangpothitham Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Premthip Chalidapongse Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Nattapon Rotpenpian Department of Oral Biology and Occlusion, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Noodchanath Kongchouy Division of Computational Sciences, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Pankaew Yakkaphan Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.

DOI:

https://doi.org/10.31584/jhsmr.20261358

Keywords:

body mass index, diagnostic accuracy, neck circumference, obstructive sleep apnea, STOP, STOP-BANG

Abstract

Objective: To evaluate the diagnostic performance of STOP, STOP-BANG, and their modifications against apnea-hypopnea index (AHI) cutoffs of ≥5 and ≥15.
Material and Methods: This retrospective cross-sectional study analyzed OSA patients (≥18 years) treated at the Dental Sleep Medicine Clinic, Prince of Songkla University, Thailand, from December 2007 to April 2021. Screening tools included STOP, STOP-BANG, and modified versions with different body mass index (BMI) and NC cutoffs. Patients were classified by AHI (≥5 and ≥15), and the accuracy of each questionnaire was evaluated against these thresholds.
Results: Of the 112 eligible patients, 66.1% were male, with a mean age of 46.9±11.9 years. For AHI ≥5, sensitivities were high: STOP (93.1%), STOP-BANG (89.8%), and modified STOP-BANG with BMI ≥30/NC ≥40 (90.8%), BMI ≥26/NC ≥40 (93.9%), and BMI ≥35/NC ≥35 (93.8%). Specificities were moderate: STOP (45.5%), STOP-BANG (54.5%), and 45.5% for all modified versions. For AHI ≥15, sensitivities remained high: STOP (91.3%), STOP-BANG (89.4%), BMI ≥30/NC ≥40 (87.9%), BMI ≥26/NC ≥40 (93.9%), and BMI ≥35/NC ≥35 (92.3%). However, specificities were low: STOP (14.0%), STOP-BANG (16.3%), modified STOP-BANG with BMI ≥ 30/NC ≥ 40 (18.6%), BMI ≥26/NC ≥40 (16.3%), and BMI ≥35/NC ≥35 (14.3%).
Conclusion: The modified STOP-BANG (BMI ≥26 kg/m², NC ≥40 cm) showed the highest sensitivity and may be the most suitable OSA screening tool in our region.

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