STOPBANG versus NOSAS in screening patients with severe obstructive sleep apnea

Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by repeated upper airway obstruction during sleep. It can lead to significant health risks, and early detection is essential for effective management.

To evaluate the diagnostic performance of STOP-BANG and NoSAS questionnaires in identifying severe OSA.

Patients with confirmed sleep disorders by ventilator polygraphy were enrolled in this cross-sectional study conducted over 18 months in the Pneumonology department of Charles Nicolle Hospital of Tunis. All participants completed STOP-BANG and NoSAS questionnaires.

A total of 172 patients diagnosed with OSA were enrolled, with a mean age of 54.4 years. OSA severity was classified as mild in 63 patients (36.6%), moderate in 45 patients (26.2%), and severe (apnea-hypopnea index ≥30/h) in 64 patients (37.2%). Severe OSA was significantly associated with male (p=0.04), older age (p=0.019), higher BMI (p<0.001), larger neck circumference (p<0.001), and greater fatigue (p=0.037). STOP-Bang and NoSAS scores demonstrated high discriminative value, with areas under the curve (AUC) of 0.61 and 0.64, respectively. STOP-BANG score showed higher sensitivity (65.2%) compared to NoSAS (34.8%), while NoSAS exhibited superior specificity (85.6% vs 53.8%). Positive predictive values were comparable between scores, but NoSAS had a slightly higher negative predictive value (82.9% vs 81.5%).

These findings suggest that while STOP-BANG is more sensitive for identifying severe OSA, NoSAS offers better specificity, making it a valuable tool for screening in specific populations. Combining both scores may enhance diagnostic accuracy and improve early detection of severe OSA, thereby optimizing patient outcomes.