The Validity and Reliability of an Arabic Version of the STOP-Bang Questionnaire for Identifying Obstructive Sleep Apnea



Ahmed S. BaHammam*, Alaa M. Al-Aqeel, Alanoud A. Alhedyani, Ghaida I. Al-Obaid, Mashail M. Al-Owais, Awad H. Olaish
The University Sleep Disorders Center, Department of Medicine, College of Medicine, and National Plan for Science and Technology, King Saud University, Riyadh, Saudi Arabia


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© BaHammam et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the University Sleep Disorders Center, College of Medicine, King Saud University, Box 225503, Riyadh 11324, Saudi Arabia; Tel: 966-1-467-1521; Fax: 966-1-467-2558;, E-mails: ashammam2@gmail.com, ashammam@ksu.edu.sa


Abstract

Background:

Obstructive sleep apnea (OSA) is a common, serious, under-recognized and under-diagnosed medical disorder. Polysomnography (PSG) is the gold standard diagnostic test for OSA; however, the cost of testing and the shortage of sleep disorders laboratories limit access to this tool. Therefore, there is a need for a simple and reliable diagnostic tool to screen patients at risk of OSA.

Objective:

This study was conducted to evaluate the validity and reliability of an Arabic version of the STOP-Bang questionnaire (SBQ) as a screening tool for OSA.

Methods:

This study was conducted in three steps, as follows: Step 1: the SBQ was translated from English to Arabic (examining both forward and backward translations); Step 2: the test-retest reliability of the questionnaire was investigated; and Step 3: the questionnaire was validated against PSG data prospectively on 100 patients attending a sleep disorders clinic who were subjected to a full-night PSG study after completing the translated version of the SBQ. The validity of the test was tested against the apnea-hypopnea index (AHI).

Results:

The study group had a mean age of 46.6 ± 14.0 years and a mean AHI of 50.0 ± 37.0/hour. The study demonstrated a high degree of internal consistency and stability over time for the translated SBQ. The Cronbach’s alpha coefficient for the 8-item tool was 0.7. Validation of the SBQ against the AHI at a cut-off of 5 revealed a sensitivity of 98% and positive and negative predictive values of 86% and 67%, respectively.

Conclusion:

The Arabic version of the SBQ is an easy-to-administer, simple, reliable and valid tool for the identification of OSA in the sleep disorders clinic setting.

Keywords:: Apnea-hypopnea index, STOP-Bang questionnaire, obstructive sleep apnea, validity, reliability, screening, sleepiness.