The STOP-BANG questionnaire improves the detection of epilepsy patients at risk for obstructive sleep apnea

Epilepsy Res. 2017 Jan;129:37-40. doi: 10.1016/j.eplepsyres.2016.11.009. Epub 2016 Nov 18.


Patients with epilepsy and obstructive sleep apnea (OSA) are at risk for worsened seizure control and quality of life. We performed a quality improvement project, evaluating for improvements in the screening of OSA in epilepsy patients using the STOP-BANG questionnaire. The electronic medical records of patients seen in our epilepsy clinic were screened for 4 months prior to the intervention. We subsequently implemented the STOP-BANG questionnaire for 3 months. Only 22/664 patients (3.3%) had their sleeping habits explored during the pre-intervention period; 11 (1.7%) were referred to sleep medicine. Following implementation of the STOP-BANG questionnaire, the percentage of patients screened for OSA increased to 41.6% (269/647, Chi-square Fisher's Exact test 2-sided p<0.001). Of the 269 patients screened, 84 (31.2%) met criteria for elevated OSA risk. Forty-one patients were referred to sleep medicine during the subsequent 3 month period, including 33 who met STOP-BANG criteria for OSA. This represented 6.3% and 5.1% (respectively) of all 647 patients, a significant improvement over the percentage referred prior to the intervention (Chi-square Fisher's Exact test 2-sided p<0.001). Twelve of the 33 patients referred based on the STOP-BANG questionnaire saw sleep medicine; 11 (91.7%) were referred for polysomnography (PSG). Of the 10 patients who underwent PSG, 9 (90%) were diagnosed with OSA and offered treatment with continuous positive airway pressure (CPAP).

Keywords: Epilepsy; OSA; Obstructive sleep apnea; STOP-BANG; Seizures.

MeSH terms

  • Epilepsy / complications*
  • Epilepsy / diagnosis*
  • Humans
  • Referral and Consultation
  • Risk
  • Sleep Apnea, Obstructive / complications*
  • Sleep Apnea, Obstructive / diagnosis*
  • Surveys and Questionnaires