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Screening for obstructive sleep apnea before surgery: why is it important?

Chung, Frances; Elsaid, Hisham

Current Opinion in Anaesthesiology: June 2009 - Volume 22 - Issue 3 - p 405–411
doi: 10.1097/ACO.0b013e32832a96e2
Anesthesia and medical disease: Edited by François Clergue

Purpose of review The purpose of this article is to review the screening tools available in the preoperative clinic for patients at risk of obstructive sleep apnea.

Recent findings Obstructive sleep apnea (OSA) is the most prevalent sleep disorder. An estimated 82% of men and 92% of women with moderate-to-severe sleep apnea have not been diagnosed. Patients with undiagnosed OSA may have increased perioperative complications. The perioperative risk of patients with OSA may be reduced by appropriate screening to detect undiagnosed OSA in patients. The snoring (S), tiredness (T) during daytime, observed apnea (O), and high blood pressure (P) (STOP) questionnaire is a concise and easy-to-use screening tool to identify patients with a high risk of OSA. It has been validated in surgical patients at preoperative clinics as a screening tool. Incorporating BMI, age, neck size and gender into the STOP questionnaire (STOP-Bang), will further increase the sensitivity and negative predictive value (NPV), especially for patients with moderate-to-severe OSA.

Summary The STOP questionnaire is short and can be easily incorporated into routine screening of general or surgical patients.

Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada

Correspondence to Dr Frances Chung, Department of Anesthesia, Toronto Western Hospital, 399 Bathurst Street, McL 2-405, Toronto, ON M5T 2S8, Canada Tel: +416 603 5118; fax: +416 603 6494; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.