Can STOP-Bang and Pulse Oximetry Detect and Exclude Obstructive Sleep Apnea?

Obstructive sleep apnea (OSA) is well established as a driver of postoperative complications. However, despite the high prevalence of OSA, most patients remain undetected in the perioperative setting, which highlights the need for simple screening tools. This prospective observational multicenter study aimed to investigate whether STOP-Bang and oxygen desaturation index can identify subjects with OSA. Analysis included 449 adult patients referred to a sleep clinic for OSA evaluation with ambulatory polysomnography, including pulse oximetry and the STOP-Bang questionnaire in 4 Swedish centers. The STOP-Bang score is the sum of 8 positive answers to Snoring, Tiredness, Observed apnea, high blood Pressure, Body mass index >35 kg/m, Age >50 years, Neck circumference >40 cm, and male Gender.

Overall, data showed that the STOP-Bang tool and pulse oximetry can be used to screen for OSA. A STOP-Bang score of <2 almost excludes moderate and severe OSA, whereas nearly all the patients with a STOP-Bang score ≥6 have OSA. The authors suggested the addition of nightly pulse oximetry in patients with a STOP-Bang score of 2-5 to enable OSA screening.