Obstructive sleep apnea risk and upper-airway symptoms among Palestinian adults in the West Bank: A cross-sectional STOP-Bang screening study

OBJECTIVE: To estimate obstructive sleep apnea (OSA) risk among Palestinian adults in the West Bank and examine associations with snoring and upper-airway symptoms. METHODS: In this cross-sectional study, 1,000 adults completed a modified Arabic STOP-Bang questionnaire with additional items on nasal obstruction, mouth breathing during sleep, drooling, recurrent tonsillitis/sore throat, and upper-airway surgery. OSA risk was classified as low, intermediate, or high. Logistic regression analyses identified factors associated with snoring and OSA risk. RESULTS: Overall, 68.1% were classified as low risk, 24.1% as intermediate risk, and 7.8% as high risk for OSA. Snoring was independently associated with male sex, extreme obesity, witnessed apnea/choking, nasal obstruction with mouth breathing, drooling, and recurrent tonsillitis/sore throat. Nasal obstruction with mouth breathing showed the strongest association with intermediate (OR=2.7) and high OSA risk (OR=8.0). CONCLUSION: Approximately one-third of participants screened as intermediate-to-high risk for OSA. Upper-airway symptoms, particularly nasal obstruction with mouth breathing, may help identify individuals requiring further diagnostic evaluation.