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

The purpose of this article is to review the screening tools available in the preoperative clinic for patients at risk of obstructive sleep apnea. 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. The STOP questionnaire is short and can be easily incorporated into routine screening of general or surgical patients.