Modified STOP-bang tool for stratifying obstructive sleep apnea risk in adolescent children

Daniel Combs, James L. Goodwin, Stuart F. Quan, Wayne J. Morgan, Sairam Parthasarathy

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Purpose: Obstructive sleep apnea (OSA) is prevalent in children and diagnostic polysomnography is costly and not readily available in all areas. We developed a pediatric modification of a commonly used adult clinical prediction tool for stratifying the risk of OSA and the need for polysomnography. Methods: A total of 312 children (age 9-17 years) from phase 2 of the Tucson Children's Assessment of Sleep Apnea cohort study, with complete anthropomorphic data, parent questionnaires, 7and home polysomnograms were included. An adolescent modification of STOP-Bang (teen STOP-Bang) was developed and included snoring, tired, observed apnea, blood pressure > 95th percentile, BMI > 95th percentile, academic problems, neck circumference >95th percentile for age, and male gender. An apnea-hypopnea index ≥ 1.5 events/hour was considered diagnostic of OSA. Results: Receiver Operator Characteristic (ROC) curves for parent-reported STOP-Bang scores were generated for teenage and pre-teen children. A STOP-Bang score of < 3 in teenagers was associated with a negative predictive value of 0.96. ROC curves were also generated based upon child-reported sexual maturity rating (SMR; n = 291). The ability of teen STOPBang to discriminate the presence or absence of OSA as measured by the AUC for children with SMR ≥ 4 (0.83; 95%CI 0.71-0.95) was better than children with SMR < 4 (0.63; 95%CI 0.46-0.81; p = 0.048). Conclusions: In community dwelling adolescents, teen STOP-Bang may be useful in stratifying the risk of OSA.

Original languageEnglish (US)
Article numbere0142242
JournalPloS one
Issue number11
StatePublished - Nov 1 2015

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General


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