Evaluation and validation of four translated Chinese questionnaires for obstructive sleep apnea patients in Hong Kong

Sleep Breath. 2014 Dec;18(4):715-21. doi: 10.1007/s11325-013-0889-1. Epub 2014 Sep 3.


Background: The present study validates and evaluates the sensitivity and specificity of four internationally popular questionnaires, translated into Chinese, for assessing suspected obstructive sleep apnea (OSA) patients, namely, the Berlin questionnaire, the ASA checklist, the STOP questionnaire and the STOP-BANG questionnaire. Their predictive values in OSA risks in patients presenting with OSA symptoms are examined. Questionnaires may be helpful in prioritizing polysomnography (PSG) and in treatment for the more severe cases.

Methods: All patients attending our sleep laboratory for overnight PSG were recruited. They were asked to complete three questionnaires (Berlin, ASA checklist and STOP) 2 weeks before and on the same night as the PSG. STOP-BANG questionnaire, an extended STOP with demographic data, 'B'-body mass index (BMI), 'A'-age, 'N'-neck circumference and 'G'-gender was completed by our technologists using the patient's completed STOP.

Results: A number of 141 patients were recruited. The sensitivities and specificities for STOP-BANG with cutoffs at PSG's RDI=5, RDI=15 and RDI=30 were 81% to 86% and 34% to 57%, respectively. The high-risk group patients identified by STOP-BANG had significantly higher respiratory disturbance index and lower minimum oxygen saturation than the low-risk group patients.

Conclusion: Among the four questionnaires studied, STOP-BANG, with only eight questions and the highest sensitivity, is the best questionnaire of the four for OSA screening. This can potentially assist in prioritizing PSG and can be helpful in clinical or self-evaluation by the general public.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Adult
  • Checklist*
  • Cross-Cultural Comparison*
  • Female
  • Hong Kong
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Polysomnography
  • Prospective Studies
  • Psychometrics / statistics & numerical data
  • Reproducibility of Results
  • Sleep Apnea, Obstructive / diagnosis*
  • Surveys and Questionnaires*
  • Translating