Design and Validation of Sleep Apnea Risk Assessment (SARA): A Screening Tool for Moderate-to-Severe Obstructive...

Area of Science:

• Sleep Medicine
• Diagnostic Tools
• Respiratory Health

Background:

• Obstructive sleep apnea (OSA) is a prevalent condition requiring effective screening.
• Existing screening tools have limitations in accuracy and efficiency.
• Early identification of high-risk individuals is crucial for timely intervention.

Purpose of the Study:

• To design and validate a concise and efficient screening tool, the Sleep Apnea Risk Assessment (SARA).
• To identify patients at high risk for moderate-to-severe obstructive sleep apnea.
• To compare the performance of SARA against established sleep apnea questionnaires.

Main Methods:

• A two-phase, multicenter study involving two cohorts (Cohort A for design, Cohort B for validation).
• Development of SARA based on six key variables: observed apnea, snoring, male sex, age, daytime fatigue, and BMI.
• Comparison of SARA's diagnostic accuracy (AUC, sensitivity) with Epworth Sleepiness Scale, Berlin Questionnaire, Pittsburgh Sleep Quality Index, STOP-Bang, and STOP.

Main Results:

• SARA demonstrated strong performance with an AUC of 0.77 in Cohort A and 0.79 in Cohort B.
• High sensitivity was observed: 87.2% in Cohort A and 98% in Cohort B at a cut-off score of ≥11.
• SARA significantly outperformed other tested screening questionnaires in identifying patients with moderate-to-severe OSA.

Conclusions:

• The Sleep Apnea Risk Assessment (SARA) is a promising new tool for screening moderate-to-severe OSA.
• SARA exhibits high sensitivity and a robust receiver operating characteristic (ROC) curve.
• Further large-scale validation studies are recommended to confirm SARA's clinical utility.