Quality of Life Research

, Volume 24, Issue 8, pp 2025–2030 | Cite as

The STOP-BANG questionnaire: reliability and validity of the Persian version in sleep clinic population

  • Khosro Sadeghniiat-Haghighi
  • Ali Montazeri
  • Ahmad Khajeh-Mehrizi
  • Mahsa Ghajarzadeh
  • Zahra Banafsheh Alemohammad
  • Omid Aminian
  • Mojtaba Sedaghat
Brief Communication

Abstract

Purpose

The snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck circumference, gender (STOP-BANG) is a concise and effective obstructive sleep apnea (OSA) screening tool, part questionnaire (STOP), and part demographic or anthropometric measurements (BANG). The main purpose of this study was to translate this well-liked questionnaire into Persian and assess its reliability and validity in sleep clinic population.

Methods

Standard forward–backward method was used for translation. A sample of 603 patients, who admitted to the sleep clinic, completely answered to the STOP questionnaire and underwent in-laboratory polysomnography, included in this study. Height, weight, and neck circumference were measured by technicians for calculating BANG score. The apnea–hypopnea index (AHI) on the polysomnography was used as gold standard for OSA diagnosis: none (AHI < 5), mild (5 ≤ AHI < 15), moderate (15 ≤ AHI < 30), and severe (AHI ≥ 30). One hundred and forty one patients were answered to the STOP questionnaire twice at a time interval of 2–4 weeks for test–retest analysis.

Results

In reliability analysis, 124 (87.9 %) patients had same STOP score and 130 (92.2 %) patients were classified in same risk of OSA. Based on the polysomnography, 438 patients (72.6 %) had mild (n = 124, 20.4 %), moderate (n = 114, 18.9 %), and severe (n = 201, 33.3 %) OSA, whereas according to the STOP-BANG, 502 patients (83.3 %) were at high risk of OSA. The sensitivity and specificity of the STOP-BANG were found to be 91.6 and 45.2 %, respectively, at AHI ≥ 5, 97.1 and 35.2 %, respectively, at AHI ≥ 15, and 98 and 29.4 %, respectively, at AHI ≥ 30. The area under the curve of the STOP-BANG for identifying mild, moderate, and severe OSA was 0.805, 0.779, and 0.755, respectively.

Conclusions

Persian version of the STOP-BANG performs similar to its original version and is an easy-to-use questionnaire which could be considered as a reliable and valid tool for OSA screening.

Keywords

STOP-BANG Obstructive sleep apnea Reliability Validity Polysomnography Persian 

References

  1. 1.
    The Report of an American Academy of Sleep Medicine Task Force. (1999). Sleep-related breathing disorders in adults: Recommendations for syndrome definition and measurement techniques in clinical research. Sleep, 22, 667–689.Google Scholar
  2. 2.
    Peppard, P. E., Young, T., Barnet, J. H., Palta, M., Hagen, E. W., & Hia, K. M. (2013). Increased prevalence of sleep-disordered breathing in adults. American Journal of Epidemiology, 177, 1006–1014.PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Young, T., Peppard, P. E., & Gottlieb, D. J. (2002). Epidemiology of obstructive sleep apnea: A population health perspective. American Journal of Respiratory and Critical Care Medicine, 165, 1217–1239.PubMedCrossRefGoogle Scholar
  4. 4.
    Amra, B., Farajzadegan, Z., Golshan, M., Fietze, I., & Penzel, T. (2011). Prevalence of sleep apnea-related symptoms in a Persian population. Sleep and Breathing, 15, 425–429.PubMedCrossRefGoogle Scholar
  5. 5.
    Khazaie, H., Najafi, F., Rezaie, L., Tahmasian, M., Sepehry, A. A., & Herth, F. J. F. (2011). Prevalence of symptoms and risk of obstructive sleep apnea syndrome in the general population. Archives of Iranian Medicine, 14, 335–338.PubMedGoogle Scholar
  6. 6.
    Kryger, M. H. (2000). Diagnosis and management of sleep apnea syndrome. Clinical Cornerstone, 2, 39–47.PubMedCrossRefGoogle Scholar
  7. 7.
    Baldwin, C. M., Griffitch, K. A., Nieto, F. J., O’Connor, G. T., Walsleben, J. A., & Redline, S. (2001). The association of sleep-disordered breathing and sleep symptoms with quality of life in the Sleep Heart Health Study. Sleep, 24, 96–105.PubMedGoogle Scholar
  8. 8.
    Finn, L., Young, T. B., Palta, M., & Fryback, D. G. (1998). Sleep-disordered breathing and self-reported general health status in the Wisconsin Sleep Cohort Study. Sleep, 21, 701–706.PubMedGoogle Scholar
  9. 9.
    Bloch, K. E. (1997). Polysomnography: A systematic review. Technology and Health Care, 5, 285–305.PubMedGoogle Scholar
  10. 10.
    Abrishami, A., Khajehdehi, A., & Chung, F. (2010). A systematic review of screening questionnaires for obstructive sleep apnea. Canadian Journal of Anaesthesia, 57, 423–438.PubMedCrossRefGoogle Scholar
  11. 11.
    Sadeghniiat-Haghighi, K., Montazeri, A., Khajeh-Mehrizi, A., Aminian, O., Rahimi-Golkhandan, A., et al. (2014). The Berlin questionnaire: Performance of the Persian version for measuring obstructive sleep apnea in sleep clinic population. Journal of Sleep Disorders: Treatment and Care, 3, 4.Google Scholar
  12. 12.
    Amra, B., Nouranian, E., Golshan, M., Fietze, I., & Penzel, T. (2013). Validation of the Persian version of Berlin sleep questionnaire for diagnosing obstructive sleep apnea. International Journal of Preventive Medicine, 4, 334–339.PubMedCentralPubMedGoogle Scholar
  13. 13.
    Chung, F., Yegneswaran, B., Liao, P., Chung, S. A., Vairavanathan, S., Islam, I., et al. (2008). STOP questionnaire: A tool to screen patients for obstructive sleep apnea. Anesthesiology, 108, 812–821.PubMedCrossRefGoogle Scholar
  14. 14.
    Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25, 3186–3191.PubMedCrossRefGoogle Scholar
  15. 15.
    Iber, C. A.-I. S., Chesson, A. L, Jr, & Quan, S. F. (2007). The AASM manual for the scoring of sleep and associated events, rules, terminology and technical specifications (1st ed.). Westchester: American Academy of Sleep Medicine.Google Scholar
  16. 16.
    Young, T., Evans, L., Finn, L., & Palta, M. (1997). Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep, 20, 705–706.PubMedGoogle Scholar
  17. 17.
    Netzer, N. C., Stoohs, R. A., Netzer, C. M., Clark, K., & Strohl, K. P. (1999). Using the Berlin questionnaire to identify patients at risk for the sleep apnea syndrome. Annals of Internal Medicine, 131, 485–491.PubMedCrossRefGoogle Scholar
  18. 18.
    Martinez, D., da Silva, R. P., Klein, C., Fiori, C. Z., Massierer, D., Cassol, C. M., et al. (2012). High risk for sleep apnea in the Berlin questionnaire and coronary artery disease. Sleep and Breathing, 16, 89–94.PubMedCrossRefGoogle Scholar
  19. 19.
    Ahmadi, N., Chung, S. A., Gibbs, A., & Shapiro, C. M. (2008). The Berlin questionnaire for sleep apnea in a sleep clinic population: Relationship to polysomnographic measurement of respiratory disturbance. Sleep and Breathing, 12, 39–45.PubMedCrossRefGoogle Scholar
  20. 20.
    Chung, F., Yegneswaran, B., Liao, P., Chung, S. A., Vairavanathan, S., Islam, I., et al. (2008). Validation of the Berlin Questionnaire and American Society of Anesthesiologists Checklist as screening tools for obstructive sleep apnea in surgical patients. Anesthesiology, 108, 822–830.PubMedCrossRefGoogle Scholar
  21. 21.
    Pecotic, R., Dodig, I. P., Valic, M., Ivkovic, N., & Dogas, Z. (2011). The evaluation of the Croatian version of the Epworth sleepiness scale and STOP questionnaire as screening tools for obstructive sleep apnea syndrome. Sleep and Breathing, 16, 793–802.PubMedCrossRefGoogle Scholar
  22. 22.
    Boynton, G., Vahabzadeh, A., Hammoud, S., Ruzicka, D. L., & Chervin, R. D. (2013). Validation of the STOP-BANG Questionnaire among patients referred for suspected obstructive sleep apnea. Journal of Sleep Disorders: Treatment and Care, 2, 4.Google Scholar
  23. 23.
    Ong, T. H., Raudha, S., Fook-Chong, S., Lew, N., & Hsu, A. A. (2010). Simplifying STOP-BANG: Use of a simple questionnaire to screen for OSA in an Asian population. Sleep and Breathing, 14, 371–376.PubMedCrossRefGoogle Scholar
  24. 24.
    Farney, R. J., Walker, B. S., Farney, R. M., Snow, G. L., & Walker, J. M. (2011). The STOP-Bang equivalent model and prediction of severity of obstructive sleep apnea: Relation to polysomnographic measurements of the apnea/hypopnea index. Journal of Clinical Sleep Medicine, 7, 459–465.PubMedCentralPubMedGoogle Scholar
  25. 25.
    Vana, K. D., Silva, G. E., & Goldberg, R. (2013). Predictive abilities of the STOP-Bang and Epworth Sleepiness Scale in identifying sleep clinic patients at high risk for obstructive sleep apnea. Research in Nursing & Health, 36, 84–94.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Khosro Sadeghniiat-Haghighi
    • 1
    • 2
  • Ali Montazeri
    • 3
  • Ahmad Khajeh-Mehrizi
    • 1
    • 4
  • Mahsa Ghajarzadeh
    • 5
  • Zahra Banafsheh Alemohammad
    • 1
    • 2
  • Omid Aminian
    • 2
  • Mojtaba Sedaghat
    • 6
  1. 1.Occupational Sleep Research CenterTehran University of Medical SciencesTehranIran
  2. 2.Center for Research on Occupational DiseasesTehran University of Medical SciencesTehranIran
  3. 3.Mental Health Research Group, Health Metrics Research CentreIranian Institute for Health Sciences Research, ACECRTehranIran
  4. 4.Department of Internal Medicine, Shariati HospitalTehran University of Medical SciencesTehranIran
  5. 5.Brain and Spinal Injury Repair (BASIR) Research CenterTehran University of Medical SciencesTehranIran
  6. 6.Department of Community MedicineTehran University of Medical SciencesTehranIran

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