STOP-Bang Questionnaire in Patients with Rapid Eye Movement Sleep Behavior Disorder

Abstract

Background and Objective The snoring, tiredness, observed apnea, and high blood pressure– body mass index, age, neck circumference, and gender (STOP-Bang) questionnaire is known as a simple but useful tool for the diagnosis of high-risk obstructive sleep apnea (OSA). However, the utility of STOP-Bang questionnaire in rapid eye movement (REM) sleep behavior disorder (RBD) populations is not validated. This study aimed to determine the diagnostic value of the STOP-Bang questionnaire in patients with RBD at high risk for OSA. Methods We collected data from 65 consecutive patients who were diagnosed with RBD in a tertiary sleep center (20 women; mean age, 64.3 ± 12.5 years). All the patients visited sleep center with complaints of abnormal behavior during sleep, and underwent testing with STOP-Bang questionnaire and polysomnography. The diagnosis of RBD was based on the International Classification of Sleep Disorders, second edition. We diagnosed OSA when apnea-hypopnea index (AHI) was at least 5/h. The receiver operating characteristic (ROC) curves were plotted. Results The mean AHI was 18.2 ± 16.5/h, and 75.4% (n = 49) had an AHI ≥ 5. The STOP-Bang (threshold ≥ 3) identified 70.7% of patients as high risk for OSA, and sensitivity, specificity, positive and negative predictive values were 81.6, 62.5, 87, and 52.6%, respectively. The area under the ROC curve (AUC) was 0.79 (p < 0.001). The STOP (threshold ≥ 2) identified 70.7% of patients at high risk for OSA, and sensitivity, specificity, positive and negative predictive values were 75.5, 87.5, 94.9, and 53.8%, respectively. The AUC was 0.86 (p < 0.001). A pairwise comparison of ROC curve between STOP-Bang and STOP was insignificant (p = 0.145). Conclusions In RBD population, the STOP-Bang or STOP questionnaire is a useful screening tool to identify patients at high risk for OSA.

Keywords

• REM sleep behavior disorder
• Obstructive sleep apnea
• Screening questionnaire