Sleep and Breathing

, Volume 22, Issue 3, pp 757–765 | Cite as

STOP-Bang questionnaire: the validation of a Portuguese version as a screening tool for obstructive sleep apnea (OSA) in primary care

  • Alexandre Rebelo-Marques
  • Cláudia Vicente
  • Bruno Valentim
  • Marcos Agostinho
  • Rosália Pereira
  • Maria Fátima Teixeira
  • Joaquim Moita
Sleep Breathing Physiology and Disorders • Original Article



The growing number of suspected patients diagnosed with obstructive sleep apnea (OSA) that are observed in sleep units has increased in the last decade. Therefore, screening methods have become important, especially in primary care (PC).


This work aimed to test the performance of the STOP-Bang questionnaire for the suspicion/diagnosis of obstructive sleep apnea.


Eight-month prospective study; all patients referred from PC to the respective sleep clinic accompanied by a completed and translated version of the STOP-Bang questionnaire for a clinical evaluation.


Two hundred fifty-nine observed patients were the study object. The age was 55.14 ± 12.07 years, 71.03% were male patients with a neck circumference of 40.97 ± 3.07 cm and BMI of 31.1 ± 5.14 kg/m2. The diagnosis was confirmed in 82.6% of the patients: 34.6% having moderate and 36.8% severe disease. A STOP-Bang score of 3 or more resulted in positive predictive value (PPV) of 88.4% and a sensitivity for OSA of 98.6%. Has the questionnaire score raises, OSA’s probability also raises in a proportional basis. For a STOP-Bang score of 6, the OSA probability reaches 98% and for a score of 8, it reaches 80% for severe OSA. Lower scores, 3 or 2, had a negative predictive value (NPV) for moderate-to-severe OSA of 86.96 and 87.5%, respectively.


As much as we know, our study is the first that applied the STOP-Bang questionnaire in Portuguese PC. We demonstrate that these is a useful tool for the stratification of patients with suspicion and diagnosis of OSA, showing a high sensitivity and PPV. Besides that, the probability of severe OSA steadily increases along with its score and we show an excellent NPV with lower scores.


Obstructive sleep apnea Polysomnography Screening tool Primary care STOP-Bang questionnaire Diagnosis 


Funding information

The authors declare that no funding was received for this research.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The authors declare that the protocol of the research work was approved by the Ethics Commission of the Regional Health Administration (ARS Centro) according to the Helsinki Declaration, and all the patients provided written informed consent.

Supplementary material


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2017

Authors and Affiliations

  • Alexandre Rebelo-Marques
    • 1
    • 2
  • Cláudia Vicente
    • 3
  • Bruno Valentim
    • 1
  • Marcos Agostinho
    • 4
  • Rosália Pereira
    • 1
  • Maria Fátima Teixeira
    • 5
  • Joaquim Moita
    • 5
  1. 1.USF Condeixa, ACeS Baixo Mondego, ARS CentroCoimbraPortugal
  2. 2.Faculty of MedicineUniversity of CoimbraCoimbraPortugal
  3. 3.UCSP Mealhada, ACeS Baixo Mondego, ARS CentroCoimbraPortugal
  4. 4.USF Santa Cruz, ACeS Oeste SulARS Lisboa e Vale do TejoLisbonPortugal
  5. 5.Sleep Medicine CentreCoimbra Hospital and University CenterCoimbraPortugal

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