OSA Screening — FRCA Final MCQ

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EasyPreoperative AssessmentOSA ScreeningFRCA Final

A 55-year-old man presents to the preoperative assessment clinic before elective knee replacement. His partner reports loud snoring and witnessed pauses in breathing during sleep, but he has not previously undergone assessment for obstructive sleep apnoea. Which questionnaire is most appropriate for estimating his risk of obstructive sleep apnoea in the preoperative setting?

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Correct answer: D — STOP-Bang Questionnaire

The correct answer is D, the STOP-Bang Questionnaire. It is a validated perioperative screening tool covering snoring, tiredness, observed apnoeas, hypertension, BMI, age, neck circumference and sex. Current RCoA guidance specifically identifies STOP-Bang as an appropriate tool for assessing sleep-apnoea risk during preoperative assessment. It estimates risk rather than establishing a diagnosis; definitive diagnosis requires an appropriate sleep study. The Epworth Sleepiness Scale measures subjective daytime sleepiness and is not sufficiently specific for perioperative OSA risk assessment. The Berlin Questionnaire can screen for OSA but is less suited to perioperative risk stratification than STOP-Bang. The Pittsburgh index assesses general sleep quality. Mallampati classification is an airway examination, not an OSA questionnaire.

Reference: Royal College of Anaesthetists. Guidelines for the Provision of Anaesthesia Services for Day Surgery 2025, section 5.31. https://www.rcoa.ac.uk/node/18556