Article Text
Abstract
Introduction Obstructive sleep apnea (OSA) is increasingly being recognised as an important health care issue. Incidence and prevalence of OSA are gradually increasing worldwide. There is increasing evidence that OSA is being considered as an independent risk factor for hypertension, diabetes mellitus, cardiovascular diseases and stroke, leading to increased cardio-metabolic morbidity and mortality. Many questionnaires are available for OSA screening. Many studies done in peri-operative population showed that the STOP-BANG questionnaire (Snoring, Tiredness, Observed apnea, high blood Pressure, BMI > 30, Age > 50, neck Circumference, Gender male) is the simplest, with a high positive predictive value. A sleep study is advised for anyone who has 3 or more positive variables from STOP-BANG. The purpose of our study was to analyse the STOP-BANG questionnaire’s validity for OSA screening in the primary care setting. Currently, there is no available screening tool for OSA in outpatient setting.
Methods Study involved a retrospective chart analysis from outpatient clinics. Patients from neurology and sleep clinic were excluded. Electronic medical record was used for patient selection. We randomly selected the first 400 patients who had 3 out of 8 variables from STOP-BANG.
Results Out of 400 selected patients, 124 (31%) had 3 variables, 180 (45%) had 4 variables, 54 (13.5%) had 5 variables, 32 (8%) had 6 variables & 10 (2.5%) had 7 variables. Neck circumference was not documented in the charts so the 8th variable was not available.
Out of 400 patients with 3–7 positive STOP-BANG variables, only 25% (100/400) received a sleep study and 73% (73/100) were diagnosed with OSA.
Conclusion Primary care physicians should screen all high-risk patients using STOP-BANG questionnaire. STOP-BANG is an affirmative screening tool in peri-operative population and our study indicates that it can also be an efficient screening questionnaire in primary care clinics. However more studies are needed to testify it. OSA is an easily diagnosable condition but often overlooked. Early recognition and treatment of obstructive sleep apnea may prevent adverse health consequences.