SLEEP BREATHING PHYSIOLOGY AND DISORDERS • ORIGINAL ARTICLE STOP-Bang questionnaire: the validation of a Portuguese version as a screening tool for obstructive sleep apnea (OSA) in primary care Alexandre Rebelo-Marques 1,2 & Cláudia Vicente 3 & Bruno Valentim 1 & Marcos Agostinho 4 & Rosália Pereira 1 & Maria Fátima Teixeira 5 & Joaquim Moita 5 Received: 28 February 2017 /Revised: 14 December 2017 /Accepted: 15 December 2017 # Springer International Publishing AG, part of Springer Nature 2017 Abstract Introduction 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). Aim This work aimed to test the performance of the STOP-Bang questionnaire for the suspicion/diagnosis of obstructive sleep apnea. Methods 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. Results 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/m 2 . 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. Conclusion 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. Keywords Obstructive sleep apnea . Polysomnography . Screening tool . Primary care . STOP-Bang questionnaire . Diagnosis Introduction Obstructive sleep apnea (OSA) is a disease with significant prevalence among people from all ages [1]. Nowadays, we know that around 20% of the population, in all age groups, can suffer from this disorder [1, 2]. There is an independent association of OSA with increased mortality and morbidity due to metabolic disorders, neurovascular and cardiovascular disease, and impaired neurocognitive function, even if asymptomatic [ 3–5]. Despite its prevalence, moderate/severe OSA could be undi- agnosed in about 82% of men and 92% of women [6]. Primary care providers (PCPs) must frequently decide which patients should be referred for OSA evaluations. This decision should be made as accurately as possible, during short patient visits, due to the conditioning of financial con- straints. An accurate screening protocol for sleep-disordered breathing (SDB) is indispensable to identify patients at risk. In the last decade, numerous tools have been made available and suggested in order to quickly identify these patients. Anecdotally, a subjective scale, like the Epworth Sleepiness Scale (ESS), has been used by PCPs to identify this risk. The * Alexandre Rebelo-Marques 1 USF Condeixa, ACeS Baixo Mondego, ARS Centro, Coimbra, Portugal 2 Faculty of Medicine, University of Coimbra, Coimbra, Portugal 3 UCSP Mealhada, ACeS Baixo Mondego, ARS Centro, Coimbra, Portugal 4 USF Santa Cruz, ACeS Oeste Sul, ARS Lisboa e Vale do Tejo, Lisbon, Portugal 5 Sleep Medicine Centre, Coimbra Hospital and University Center, Coimbra, Portugal Sleep and Breathing https://doi.org/10.1007/s11325-017-1608-0