Indian Journal of Sleep Medicine

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VOLUME 14 , ISSUE 3 ( July-September, 2019 ) > List of Articles

Original Article

Comparison of Epworth Sleepiness Scale and STOP-BANG Questionnaire for Diagnosing Obstructive Sleep Apnea at a Tertiary Care Centre in North India: A Retrospective Study

Mansunderbir Singh, Vidushi Rathi

Keywords : Epworth sleepiness scale, Obstructive sleep apnea, Polysomnography, Screening, STOP-BANG questionnaire

Citation Information : Singh M, Rathi V. Comparison of Epworth Sleepiness Scale and STOP-BANG Questionnaire for Diagnosing Obstructive Sleep Apnea at a Tertiary Care Centre in North India: A Retrospective Study. Indian Sleep Med 2019; 14 (3):46-50.

DOI: 10.5005/jp-journals-10069-0042

License: CC BY-NC 4.0

Published Online: 01-09-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: The diagnosis of obstructive sleep apnea (OSA) requires polysomnography (PSG). The screening of OSA utilizes questionnaires like the Epworth sleepiness scale (ESS) and the STOP-BANG questionnaire (SBQ) that have variable predictive value, as reported from the Western literature. Materials and methods: A retrospective cohort study was done in adult subjects (n = 80) presenting with symptoms of OSA. The demographic profile, ESS, and SBQ scores were evaluated. The level one recorded PSG was evaluated for apnea–hypopnea index (AHI) and positive airway pressure (PAP) therapy prescribed. Results: Of the 80 subjects, 75 were diagnosed as OSA on PSG. The mean age of the study group was 49 years, with 71% men and a mean BMI of 28.25 kg/m2. Epworth sleepiness scale ≥11 was in 62.66%, and SBQ ≥ 5 in 53% of the 75 subjects. Hence, both questionnaires failed to predict OSA in nearly half of the population. The mean AHI was 33.8/hour, and the mean continuous positive airway pressure (CPAP) was 10.05 cm H2O. The AHI had a significant correlation with BMI, ESS score, and CPAP. Epworth sleepiness scale had a 53% sensitivity and 60% specificity for diagnosing OSA using a cutoff of 11, whereas SBQ had a 68% sensitivity and 100% specificity using a cutoff of 5. Conclusion: The SBQ has a higher sensitivity and specificity to detect OSA than ESS as it envisages distinct clinical manifestations and risk factors of OSA. However, neither of the two can replace PSG.


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  1. Amra B, Farajzadegan Z, Golshan M, et al. Prevalence of sleep apnea-related symptoms in a persian population. Sleep Breath 2011;15(3):425–429. DOI: 10.1007/s11325-010-0353-4.
  2. Amra B, Nouranian E, Golshan M, et al. Validation of the persian version of berlin sleep questionnaire for diagnosing obstructive sleep apnea. Int J Prev Med 2013;4(3):334–339.
  3. Pamidi S, Aronsohn RS, Tasali E. Obstructive sleep apnea: role in the risk and severity of diabetes. Best Pract Res Clin Endocrinol Metab 2010;24(5):703–715. DOI: 10.1016/j.beem.2010.08.009.
  4. Chiu HY, Chen PY, Chuang LP, et al. Diagnostic accuracy of the berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: a bivariate meta-analysis. Sleep Med Rev 2017;36:57–70. DOI: 10.1016/j.smrv.2016.10.004.
  5. Nagappa M, Liao P, Wong J, et al. 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;10(12):e0143697. DOI: 10.1371/journal.pone.0143697.
  6. Nagappa M, Wong J, Singh M, et al. An update on the various practical applications of the STOP-bang questionnaire in anesthesia, surgery, and perioperative medicine. Curr Opin Anaesthesiol 2017;30:118–125. DOI: 10.1097/ACO.0000000000000426.
  7. Sharma A, Molano J, Moseley BD. The STOP-BANG questionnaire improves the detection of epilepsy patients at risk for obstructive sleep apnea. Epilepsy Res 2017;129:37–40. DOI: 10.1016/j.eplepsyres. 2016.11.009.
  8. Chung F, Yegneswaran B, Liao P, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology 2008;108(5):812–821. DOI: 10.1097/ALN.0b013e31816d83e4.
  9. Berry RB, Gamaldo CE, Harding SM, et al. AASM scoring manual version 2.2 updates: new chapters for scoring infant sleep staging and home sleep apnea testing. J Clin Sleep Med 2015;11(11):1253–1254. DOI: 10.5664/jcsm.5176.
  10. Dixit R, Verma S, Pawar KS. Screening for obstructive sleep apnea using epworth sleepiness score and berlin questionnaire: Which is better? Indian J Respir Care 2018;7:33–36. DOI: 10.4103/ijrc.ijrc_20_17.
  11. Mittal A, Suri JC, Chakrabarti S, et al. Therapeutic cure of obesity hypoventilation syndrome resulting in cure of obstructive sleep apnea and metabolic syndrome. Indian Sleep Med 2019;14(1):18–21. DOI: 10.5005/jp-journals-10069-0034.
  12. Chakrabarti S, Darisetty S, Gupta N, et al. Masking of obstructive sleep apnoea by drug induced central sleep apnoea – a case report. Adv Respir Med 2019;87(3):189–193. DOI: 10.5603/ARM.2019.0030.
  13. Kunisaki KM, Brown KE, Fabbrini AE, et al. STOP-BANG questionnaire performance in a veterans affairs unattended sleep study program. Ann Am Thorac Soc 2014;11(2):192–197. DOI: 10.1513/AnnalsATS.201305-134OC.
  14. Nicholl DD, Ahmed SB, Loewen AH, et al. Diagnostic value of screening instruments for identifying obstructive sleep apnea in kidney failure. J Clin Sleep Med 2013;9(1):31–38. DOI: 10.5664/jcsm.2334.
  15. Prasad KT, Sehgal IS, Agarwal R, et al. Assessing the likelihood of obstructive sleep apnea: a comparison of ninescreening questionnaires. Sleep Breath 2017;21(4):909–917. DOI: 10.1007/s11325-017-1495-4.
  16. Saxena M, Gothi D, Sah R, et al. Utility of combining Epworth sleepiness scale, stop-bang and perioperative sleep apnea prediction score for predicting absence of obstructive sleep apnea. Indian Sleep Med 2018;13(4):62–66. DOI: 10.5005/jp-journals-10069-0028.
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