{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:12:21Z","timestamp":1791396741372,"version":"4.3.3"},"reference-count":29,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Obstructive sleep apnea (OSA) is a common clinical condition. Due to its high prevalence, the waiting list for polysomnography is often long. A screening tool is needed to identify individuals at high risk for OSA who should undergo polysomnography. The STOP-Bang questionnaire is a widely used screening tool; however, it may require modification for individuals with a body mass index (BMI) below 35 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . This study aimed to evaluate whether the STOP-Bang questionnaire should be modified for patients with a BMI under 35 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective analytical study included adult patients suspected of having OSA who underwent polysomnography. Exclusion criteria included pregnancy and a BMI over 35 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      or meeting criteria for bariatric surgery. Patients were categorized into OSA and non-OSA groups. Logistic regression analysis was used to assess the predictive value of STOP-Bang factors for OSA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 188 patients were included, of whom 158 (84.04%) were diagnosed with OSA. Among the eight STOP-Bang criteria, only age was independently associated with OSA after adjustment for other variables (adjusted odds ratio: 1.04; 95% CI [1.02\u20131.08]). Optimal cut-off points for predicting OSA were identified as age \u2265 40 years (sensitivity: 84.18%), BMI \u2265 23 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (sensitivity: 82.91%), and neck circumference \u2265 35 cm (sensitivity: 86.08%). A modified STOP-Bang score incorporating these cut-offs showed improved sensitivity at a score of 3: 93.0% for apnea-hypopnea index (AHI) \u2265 5 events\/hr, 95.9% for AHI \u2265 15 events\/hr, and 97.6% for AHI \u2265 30 events\/hr. In comparison, the original STOP-Bang score of 3 had sensitivities of 50.0%, 53.6%, and 56.1% for AHI \u2265 5 events\/hr, AHI \u2265 15 events\/hr, and AHI &gt; 30 events\/hr, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The STOP-Bang questionnaire may require modification for individuals with a BMI below 35 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      who are suspected of having OSA. Revised cut-off values for age, neck circumference, and BMI\u201440 years, 35 cm, and 23 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , respectively\u2014may enhance its diagnostic performance.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.20310","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T08:38:30Z","timestamp":1762850310000},"page":"e20310","source":"Crossref","is-referenced-by-count":1,"title":["Modified STOP-Bang questionnaire for detecting obstructive sleep apnea in individuals with a body mass index below 35 kg\/m\n                    <sup>2<\/sup>"],"prefix":"10.7717","volume":"13","author":[{"given":"Napassorn","family":"Sinsopa","sequence":"first","affiliation":[{"name":"Department of Medicine, Khon Kaen University, Khon Kaen, 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