Modified STOP-bang questionnaire incorporating morning dry mouth and BMI adjustment in China: a retrospective study of 590 patients

ABSTRACT

Background

Morning dry mouth (MDM) is a common symptom of Obstructive Sleep Apnea (OSA) yet current OSA screening tools overlook it.

Objective

To enhance the specificity of the Stop-Bang questionnaire (SBQ) by adding an MDM symptom.

Method

A retrospective analysis on 590 patients from Peking University First Hospital (2013–2018) suspected of OSA was conducted. They underwent polysomnography. The research incorporated the MDM symptom into SBQ and adjusted the body mass index (BMI) threshold to 28 kg/m². Predictive parameters were then calculated.

Results

83.1% patients were diagnosed with OSA, with 61.4% reporting MDM. Multivariate regression confirmed MDM significantly influenced Apnea-Hypopnea Index (AHI). Adjusted SBQ with MDM showed a slight decrease in sensitivity but improved specificity, especially when using a BMI threshold of > 28 kg/m². For AHI ≥ 5 events/h and AHI ≥ 15 events/h, adjusted SBQ with MDM (BMI >28 kg/m²) obtained the highest Youden index.

Conclusion

Incorporating the MDM symptom into SBQ and adjusting the BMI threshold enhances the diagnostic specificity for OSA.

KEYWORDS:

• Apnea, sleep
• body mass index
• health surveys
• polysomnography
• xerostomia

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Author contributions

Conception and Design – Guangfa Wang and Jing Ma; Analysis and Interpretation of Data – Xiaoyu Ma, Cheng Zhang, Liping Feng, and Yane Shen; Drafting of the Manuscript – Xiaoyu Ma and Cheng Zhang; Critical Revision for Intellectual Content – Cheng Zhang and Guangfa Wang; Final Approval of the Version to be Published – Guangfa Wang. All authors have agreed to be accountable for all aspects of the work.

Reviewer disclosures

Peer reviewers on this manuscript have received an honorarium from Expert Review of Respiratory Medicine for their review work, but have no other relevant financial relationships to disclose.

Additional information

Funding

This work was supported by the Young Scientist Funds of National Natural Science Foundation of China [82000096].