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. 2022 Feb;28(2):280-288.
doi: 10.1177/13524585211013014. Epub 2021 May 28.

Validation of an obstructive sleep apnea symptom inventory in persons with multiple sclerosis

Mini Singh  1 , Ronald Gavidia  2 , Galit Levi Dunietz  2 , Elizabeth Washnock-Schmid  3 , Andrew R Romeo  3 , Shelley Hershner  2 , Ronald D Chervin  2 , Tiffany J Braley  4
Affiliations

Validation of an obstructive sleep apnea symptom inventory in persons with multiple sclerosis

Mini Singh et al. Mult Scler. 2022 Feb.

Abstract

Background: Improved screening for obstructive sleep apnea (OSA) could enhance multiple sclerosis (MS) clinical care; yet the utility of current screening tools for OSA have yet to be evaluated in persons with multiple sclerosis (PwMS).

Objectives: The STOP-Bang Questionnnaire is an 8-item screening tool for OSA that is commonly used in non-MS samples. The aim of this study was to assess the validity of the STOP-Bang in PwMS.

Methods: STOP-Bang and polysomnography data were analyzed from n = 200 PwMS. Sensitivity, specificity, positive-, and negative-predictive value (PPV and NPV) were calculated, with receiving operating characteristic (ROC) curves, for each STOP-Bang threshold score, against polysomnography-confirmed OSA diagnosis at three apnea severity thresholds (mild, moderate, and severe).

Results: Nearly 70% had a STOP-Bang score of ⩾3% and 78% had OSA. The STOP-Bang at a threshold score of 3 provided sensitivities of 87% and 91% to detect moderate and severe OSA, respectively; and NPV of 84% and 95% to identify PwMS without moderate or severe OSA, respectively. Sensitivity to detect milder forms of OSA was 76%. The NPV to identify persons without milder forms of OSA was 40%.

Conclusion: The STOP-Bang Questionnaire is an effective tool to screen for moderate and severe OSA in PwMS, but may be insufficient to exclude mild OSA.

Keywords: Multiple sclerosis; STOP-Bang; brainstem; fatigue; obstructive sleep apnea; sleepiness.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors have no relevant conflicts of interest to report.

Figures

Figure 1:
Figure 1:
Distribution of STOP-Bang score for the entire sample
Figure 2:
Figure 2:
Distribution of STOP-Bang score by obstructive sleep apnea diagnosis
Figure 3:
Figure 3:
ROC curve of the STOP-Bang for apnea-hypopnea index cutoffs of 5, 15, and 30
See this image and copyright information in PMC

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