The STOP-BANG Questionnaire as a Screening Tool for Obstructive Sleep Apnoea in Pregnancy

Study Objectives We examined the validity of the STOPBANG questionnaire and a modified STOPBANG to screen for obstructive sleep apnea (OSA) in obese women during the second trimester of pregnancy.Methods Ninety-nine pregnant women aged ≥18 years with body mass index ≥40 kg/m2completed the STOPBANG questionnaire during their second trimester. The number of oxygen desaturation events (≥4% from baseline) was measured using overnight pulse oximetry, with OSA defined as ≥5 events/hour. A Modified STOPBANG score was derived by replacing the ‘Tired’ item with Epworth score ≥10. Seven candidate models were compared using information theoretic criteria: STOPBANG, Modified STOPBANG and individual STOPBANG items (Snore, Tired, Observed to stop breathing, high blood Pressure and Neck circumference). We used penalised logistic regression and negative binomial regression to derive predicted probabilities of having OSA and the predicted total event counts.Results The predicted probability of meeting oximetry criteria for OSA increased with higher STOPBANG scores, from <10% for a score <3 to 68% with a score of 6. The total number of disordered breathing events was 1.26 (95% CI 1.06 to 1.50) times greater for a 1-unit increase in STOPBANG. Of the candidate models, the best relative fit was the Snore item followed by STOPBANG score (essentially equivalent). The predicted probability of having OSA was 5.0% for no snoring and 26.4% for snoring.Conclusions STOPBANG has been shown to be a useful screening tool for OSA in obese pregnant women; however the snoring question alone might be a simpler, effective predictor.