Comparison of the OSA50, STOP and STOP-BANG Questionnaires for Identification of Obstructive Sleep Apnea in a Male Population Cohort

Ching Li Chai-Coetzer, Robert Adams, Sarah Appleton, Andrew Vakulin, Sean Martin, Janet Grant, Nick Antic, Peter Catcheside, Anne Taylor, Gary Wittert, R. Doug McEvoy

Research output: Contribution to journalMeeting Abstractpeer-review


Introduction: The 4-item OSA50 questionnaire was previously developed
and validated for identifying patients at high risk for moderateto-
severe OSA in primary care. Its performance in comparison to
alternative OSA screening tools in the general population is currently
unknown. The aim of this study was to compare the performance of
OSA50, STOP and STOP-BANG questionnaires for detecting OSA using
data from a South Australian population cohort of men aged over 40
years who participated in the Men Androgen Inflammation Lifestyle
Environment and Stress (MAILES) sleep sub-study.
Methods: Participants in the MAILES study who had not been previously
diagnosed with OSA and had successfully undergone home
polysomnography (PSG) with complete data to derive responses for the
OSA50, STOP and STOP-BANG questionnaires were included. Receiver
operating characteristic (ROC) curve analyses were conducted to assess
questionnaire performance for detecting moderate-to-severe OSA (PSG
apnoea-hypopnea index [AHI] ≥ 20/hr [American Academy of Sleep
Medicine 2007 alternate criteria]) both alone and in combination with
oximetry1 (≥3% oxygen desaturation index [3%ODI] ≥ 16/hr).
Results: 543 men were included in the analyses. ROC area under the
curve (AUC) values for OSA50, STOP and STOP-BANG questionnaires
were 0.66 (95%CI: 0.61–0.71), 0.61 (0.55–0.66) and 0.65 (0.60–0.71),
respectively. There were no significant differences in ROC AUCs
between the OSA50 and the STOP or STOP-BANG questionnaires.
Using an OSA50 questionnaire score cut-point of ≥5 (which
maximised sensitivity with reasonable specificity), a two-step diagnostic
model of screening questionnaire followed by oximetry had a sensitivity
of 73%, specificity of 96%, and 91% of participants were correctly
Discussion: In a male population cohort, the 4-item OSA50 questionnaire
performed similarly to the 8-item STOP-BANG questionnaire in
identifying participants at high risk of moderate-to-severe OSA. The
OSA50 questionnaire combined with oximetry detected moderate-tosevere
OSA with a high degree of accuracy. It may have more appeal as
a screening tool because of its brevity and ease of administration. Its
utility as a screen for OSA in the female population warrants further
Original languageEnglish
Article number051
Pages (from-to)14
Number of pages1
JournalSleep and Biological Rhythms
Issue numberS1
Publication statusPublished - Oct 2015
EventSleep Down Under 2015 Cycles - Melbourne, Australia
Duration: 22 Oct 201524 Oct 2015
Conference number: 27th


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