LAUSR

Racial disparities in the prevalence and severity of Obstructive Sleep Apnea (OSA) in Black Americans may play an important contributory role in the increased burden of cardiometabolic disease experienced by this population. Effective screening for OSA could permit early recognition and treatment, thereby preventing future the adverse cardiovascular outcomes which contribute to a decreased life expectancy. The STOP-BANG questionnaire is a validated screening tool for OSA as demonstrated in many populations and settings. Unfortunately, Blacks have typically been underrepresented in studies evaluating the sensitivity and specificity of the tool. Potentially unique biologic and psychosocial factors may affect the phenotypic expression of OSA and influence the performance of the STOP-BANG. Data are needed regarding the reliability of the tool for this population and potentially modifications to optimize its usefulness. Data were from 204 patients evaluated at the Howard University Hospital Sleep Disorder Center between April 2018 and June 2019. Records were reviewed for demographic information, body mass index (BMI), neck circumference, and medical history, including the presence of snoring, tiredness/sleepiness, observed apneas, and hypertension and results of sleep study testing. Data were analyzed using SPSS software. Subcomponents of the STOP-BANG scoring criteria were adjusted to improve performance. Mean age was 48.5. 62% of subjects were female and mean BMI was 40.2 The mean ESS was 9.9. The mean AHI was 27.7 with a prevalence of mild or greater OSA (AHI >5) of 80%. Scoring of the STOP-BANG using a criterion of 3 or greater as indicating increased risk demonstrated a sensitivity of 90%, specificity of 8%, PPV of 80%, and NPV of 17%. Performance was worse for women then men. Multiple adjustments to scoring were evaluated to improve accuracy. Similar to its performance in other populations, the STOP-BANG demonstrated high sensitivity but very poor specificity and overall poor accuracy in a Black population referred for Sleep Medicine Consultation to an urban university hospital. Performance was worse for women than men. Modifications are presented to try to improve performance and the clinical utility for this population. Howard University RCMI