Association Between Suicidal Behaviors and Obstructive Sleep Apnea Based on the STOP-Bang Questionnaire: A Nationwide Population-Based Study

Chang Hoon Han, MD, PhD; Joohyng Son, MD; Jae Ho Chung, MD, PhD

J Clin Psychiatry 2025;86(1):24m15345

Abstract

Objectives: We studied the association between obstructive sleep apnea (OSA) based on STOP-Bang questionnaire and suicidal risk behaviors (ideations, plans, and attempts) in the general population using a nationally representative sample from South Korea.

Methods: Data were obtained from 11,917 adults (aged ≥40 years) who participated in the Korea National Health and Nutrition Examination Survey (2019−2020). Multiple logistic regression analyses were used to evaluate the association between suicidal behaviors and intermediate-high risk OSA (STOP-Bang score ≥3).

Results: Poor health status, severe stress, less sleep time, poor quality of life, and depression were significantly more common in the intermediate-high risk OSA group compared to the low risk OSA group. The proportions of the intermediate-high risk OSA group who had suicidal ideation (2.5%), suicidal planning (1.8%), and suicidal attempts (0.5%) were higher than those in the low risk OSA group (1.1%, 1.2%, 0.1%; P < .001, respectively). A multivariate analysis after adjusting revealed that the odds ratios for suicidal ideations, planning, and attempts were 1.42 (95% confidence interval [CI]: 1.00–2.02), 1.21 (95% CI: 1.01–1.77), and 3.29 (95% CI: 1.50–7.24), respectively, in the intermediate-high risk OSA group.

Conclusions: Moderate-high risk groups of OSA based on the STOP-Bang questionnaire were associated with suicidal behaviors in a Korean population.

J Clin Psychiatry 2025;86(1):24m15345

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