ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2022
STOP-BANG screener vs objective obstructive sleep apnea testing among younger veterans with PTSD and insomnia: STOP-BANG does not sufficiently detect risk.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02774642 (The Impact of Integrated CBT-I and PE on Sleep and PTSD Outcomes), which is not on this map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Impact of Integrated CBT-I and PE on Sleep and PTSD Outcomes
Who cites it
5 citing papers in PubMed, 10 citations in OpenAlex.
- The triangulation of multimorbidity: A systematic review of primary sleep disorders, hypertension, and psychiatric disorders.PLOS global public health · 2025Article
- The effect of obstructive sleep apnea severity on PTSD symptoms during the course of esketamine treatment: a retrospective clinical study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Article
- Examining the bidirectional relationship between posttraumatic stress disorder symptom clusters and PAP adherence.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Article
- Serum Cytokines as Biomarkers in Heart Failure with Preserved Ejection Fraction and Sleep Apnea: A Prospective Cohort Study.Life (Basel, Switzerland) · 2023Article
- Diagnostic performance of screening tools for the detection of obstructive sleep apnea in people living with HIV.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesPosttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA) cooccur even in veterans who are younger with lower body mass index. The STOP-BANG screener for OSA relies heavily on high blood pressure, age, and body mass index and may not generalize to veterans with PTSD. The inability to effectively screen veterans for OSA is problematic given negative outcomes of untreated OSA.
methodsOur study compared the STOP-BANG to objective OSA diagnostic testing in 48 younger veterans (mean age 43.7 years; 43.8% Caucasian; 20.8% female) seeking treatment for PTSD and insomnia. Apnea-hypopnea events per hour (apnea-hypopnea index), recorded by NOX T3 sleep monitors, were used to diagnose OSA (apnea-hypopnea index ≥ 5 events/h). Logistic regressions examined how STOP-BANG cut-off scores (≥ 3 and ≥ 5) classified OSA status (apnea-hypopnea index ≥ 5 events/h). Follow-up chi-square goodness-of-fit tests examined single-item STOP-BANG performance in the OSA-positive subsample (n = 28).
resultsThe STOP-BANG (≥ 3) had good sensitivity (92.6%) but poor specificity (47.6%) and negative (0.16) and positive (1.77) likelihood ratios. The STOP-BANG (≥ 5) led to improved specificity (76.19%), but sensitivity (37.04%) and positive (1.56)/negative likelihood ratios (0.83) were poor. Single-item OSA subgroup analyses revealed that body mass index, age, and neck circumference performed poorly, while tiredness and sex performed well.
conclusionsFindings suggest that the STOP-BANG correctly diagnosed OSA in some veterans but missed OSA in large number of younger veterans with PTSD. This suggests objective diagnostic OSA testing is needed in veterans with PTSD. Future research is needed to develop more accurate OSA screening measures in this population. CLINICAL
trial registrationRegistry: ClinicalTrials.gov; Name: Integrated CBT-I on PE and PTSD Outcomes (Impact Study); URL: https://www.clinicaltrials.gov/ct2/show/NCT02774642; Identifier: NCT02774642. CITATION: Lyons R, Barbir LA, Owens R, Colvonen PJ. STOP-BANG screener vs objective obstructive sleep apnea testing among younger veterans with PTSD and insomnia: STOP-BANG does not sufficiently detect risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.