The utility of three screening questionnaires for obstructive sleep apnea in a sleep clinic setting

Yonsei Med J. 2015 May;56(3):684-90. doi: 10.3349/ymj.2015.56.3.684.


Purpose: The aim of this study was to determine the diagnostic value of three screening questionnaires in identifying Korean patients at high risk for obstructive sleep apnea (OSA) in a sleep clinic setting in Korea.

Materials and methods: Data were collected from 592 adult patients with suspected OSA who visited a sleep center. All patients completed the Sleep Apnea of Sleep Disorder Questionnaire (SA-SDQ), the Berlin questionnaire, and the STOP-Bang questionnaire. Estimated OSA risk was compared to a diagnosis of OSA. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each questionnaire.

Results: The prevalence of OSA was 83.6% using an apnea-hypopnea index (AHI) ≥5/h and 58.4% for an AHI ≥15/h. The STOP-Bang questionnaire had a high sensitivity (97% for AHI ≥5/h, 98% for AHI ≥15/h), but the specificity was low (19% and 11%, respectively). In contrast, the sensitivity of the SA-SDQ was not high enough (68% for AHI ≥5/h, 74% for AHI ≥15/h) to be useful in a clinical setting, whereas the specificity was relatively good (66% and 61%, respectively). The sensitivity and specificity values of the Berlin questionnaire fell between those of the STOP-Bang questionnaire and the SA-SDQ.

Conclusion: The STOP-Bang questionnaire may be useful for screening OSA in a sleep clinic setting, but its specificity is lower than the acceptable level for this purpose. A new screening questionnaire with a high sensitivity and acceptable specificity is therefore needed in a sleep clinic setting.

Keywords: Obstructive sleep apnea; screening questionnaires; sleep disorders.

MeSH terms

  • Adult
  • Asian People / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Polysomnography / methods
  • Predictive Value of Tests
  • Prevalence
  • ROC Curve
  • Reproducibility of Results
  • Republic of Korea / epidemiology
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / diagnosis*
  • Sleep Apnea, Obstructive / ethnology
  • Surveys and Questionnaires*