Sleep and Breathing

, Volume 16, Issue 4, pp 1255–1265 | Cite as

Sleepiness, fatigue, and risk of obstructive sleep apnea using the STOP-BANG questionnaire in multiple sclerosis: a pilot study

  • Robert A. Dias
  • Kimberly A. Hardin
  • Heather Rose
  • Mark A. Agius
  • Michelle L. Apperson
  • Steven D. BrassEmail author
Original Article



This study aims: (1) to identify patients with multiple sclerosis (MS) who are at high risk for obstructive sleep apnea (OSA) by utilizing the STOP-BANG questionnaire and (2) to evaluate the relationship between OSA risk as determined by the STOP-BANG questionnaire and self-reported sleepiness and fatigue using the Epworth Sleepiness Scale (ESS) and the Fatigue Severity Scale (FSS), respectively.


A total of 120 consecutive patients presenting to the UC Davis Neurology MS Clinic were invited to participate in an anonymous survey. The exclusion criteria were: age <18 years, indefinite MS diagnosis, or incomplete survey.


There were 103 subjects included in our study: 42% of subjects (n = 43) met the criteria for high-risk OSA, 69% of subjects (n = 71) screened high for fatigue (FSS ≥ 4), but only 24 subjects (23%) screened high for excessive daytime sleepiness (ESS > 10). In males, 44% of the variation in ESS scores and 63% in FSS scores were explained by the STOP-BANG components. However, only 17% of the variation in ESS scores and 15% of the variation in FSS scores was explained by the STOP-BANG components in females.


Over 40% of MS patients were identified as high risk for OSA based on the STOP-BANG questionnaire. The STOP-BANG questionnaire offers clinicians an efficient and objective tool for improving detection of OSA risk in MS patients.


Obstructive sleep apnea Multiple sclerosis Sleepiness Fatigue 



Apnea–hypopnea index


Body mass index




Epworth Sleepiness Scale


Fatigue Severity Scale


Obstructive sleep apnea


Multiple sclerosis




University of California



The authors would like to thank Steffany Lim, clinical research coordinator in UC Davis Department of Neurology, for her assistance in overseeing the administration of the survey and data collection.

Conflicts of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Robert A. Dias
    • 1
    • 2
  • Kimberly A. Hardin
    • 1
  • Heather Rose
    • 3
  • Mark A. Agius
    • 2
  • Michelle L. Apperson
    • 2
  • Steven D. Brass
    • 2
    Email author
  1. 1.Department of Pulmonary, Critical Care and Sleep MedicineSacramentoUSA
  2. 2.Department of NeurologyUC Davis Medical CenterSacramentoUSA
  3. 3.School of EducationUC DavisDavisUSA

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