Obstructive sleep apnoea is common and mostly undiagnosed, and it worsens hypertension, atrial fibrillation and perioperative risk. The STOP-Bang questionnaire takes two minutes: Snoring loudly, Tiredness in the day, Observed apnoeas, high blood Pressure, BMI over 35, age over 50, neck circumference over 40 cm, and male sex.
A score of 0 to 2 makes moderate to severe sleep apnoea unlikely. A score of 5 or more makes it likely and justifies a sleep study. Scores of 3 to 4 are intermediate; a score of 3 or 4 plus male sex, a large neck or a BMI over 35 raises the probability.
Asian patients develop sleep apnoea at lower BMI because of craniofacial anatomy, so a lower BMI threshold is often used in South Asian populations.
- Ask STOP-Bang questions in patients with resistant hypertension, atrial fibrillation or obesity
- Arrange a sleep study at a score of 5 or more
- Remember sleep apnoea occurs at lower BMI in South Asian patients
- Ask a bed partner about observed pauses in breathing whenever possible
Why it matters
Effective treatments for sleep apnoea are multiplying, so finding the patients matters more.
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