Comparison of NoSAS score with Berlin and STOP-BANG scores for sleep apnea detection in a clinical sample

Herschmann, Stefano; Berger, Mathieu; Haba‐Rubio, José; Heinzer, Raphaël

doi:10.1016/j.sleep.2021.01.004

Cited by 17 publications

(9 citation statements)

References 14 publications

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“…Males had higher continuous scores in BQ, STOP-Bang, NoSAS, and mean values of ODI, BMI and NC, all previously associated with OSA onset. It is well known that STOP-Bang, NoSAS and BQ are instruments for screening OSA, exhibiting good predictive values, especially, when used as continuous variables, associated with both AHI and ODI measures (Peng at al., 2018;Herschmann et al, 2021& Veugen et al, 2021. In our sample, however, considerable discrepancy was observed between the objective and subjective measures.…”

Section: Discussioncontrasting

confidence: 60%

Obstructive sleep apnea and related symptoms in medical students

Costa

Lorenzi-Filho

Marzano‐Rodrigues

et al. 2022

RSD

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Objective: This prospective and cross-sectional study investigated the occurrence of obstructive sleep apnea (OSA) and related symptoms in medical students. Method: Sociodemographic and anthropometric data were collected. The survey included the Epworth sleepiness scale, Berlin questionnaire, STOP-Bang, and NoSAS. Participants underwent overnight digital monitoring of respiratory events (≥ 3% drop in SpO2) using a high-resolution oximeter. Those with high risk for OSA in the Berlin questionnaire or an oxygen desaturation index ≥ 5 to < 15 events/hour, were examined through type 3 polysomnography. Results: The evaluated sample comprised 64 students, aged 22.3±2.3 years, and 38 (59.4%) males. A high risk for OSA frequency was detected in 10.9% of the sample through the Berlin questionnaire, and in 4.7% through STOP-Bang and NoSAS. A mild form of this disorder was diagnosed in 4.7% of the sample through type 4 polysomnography, and in 6.2% using type 3 polysomnography. Excessive daytime sleepiness and being overweight were associated with the occurrence of mild obstructive sleep apnea (p ≤0.05). Males presented higher body mass index values, neck circumference, oxygen desaturation index events/hour, and continuous values in the Berlin questionnaire, STOP-Bang, and NoSAS, than females (p ≤0.05). Conclusion: Despite a low occurrence of the assessed sleep-disordered breathing among medical students, male gender, overweight and sleepiness consisted of factors associated with obstructive sleep apnea, indicating that medical students with this profile should be early and systematically screened for this condition.

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Section: Discussioncontrasting

confidence: 60%

Obstructive sleep apnea and related symptoms in medical students

Costa

Lorenzi-Filho

Marzano‐Rodrigues

et al. 2022

RSD

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“…It is important to note that high sensitivity and sufficient specificity of screening tools are generally the desired outcomes of all studies. In this study, although the sensitivity of GOAL+NHR and GOAL+NC at the optimal cut-off value is low (73.31 and 70.12%), they are within the acceptable range ( Herschmann et al, 2021 ), and the fact that they have high specificity (83.78 and 86.49) resulted in robust predictive performance could not be ignored. In addition, both GOAL+NHR and GOAL+NC had higher PPV for any prediction of OSA, which make it therefore much more useful to rule in than to rule out a possible diagnosis of OSA.…”

Section: Discussionmentioning

confidence: 66%

Incorporating neck circumference or neck-to-height ratio into the GOAL questionnaire to better detect and describe obstructive sleep apnea with application to clinical decisions

et al. 2022

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ObjectiveAlthough neck circumference (NC) and neck-to-height ratio (NHR) have been recognized as effective predictors of the clinical diagnosis of adult obstructive sleep apnea (OSA), they have not been included in the widely used GOAL questionnaire. Not coincidentally, the NHR has not been adequately considered in the development and validation of the STOP-Bang questionnaire, No-Apnea score and the NoSAS score. The motivation for the study was (1) to combine the GOAL questionnaire with the NC and NHR, respectively, to evaluate its predictive performance and (2) to compare it with the STOP-Bang questionnaire, the No-Apnea score, the NOSAS score, and the GOAL questionnaire.Materials and methodsThis retrospectively allocated cross-sectional study was conducted from November 2017 to March 2022 in adults who underwent nocturnal polysomnography (PSG) or home sleep apnea testing (HSAT). In this paper, the GOAL questionnaire was combined with the NC and NHR, respectively, using logistic regression. The performance of the six screening tools was assessed by discriminatory ability [area under the curve (AUC) obtained from receiver operating characteristic (ROC) curves] and a 2 × 2 league table [including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR−)] and compared under AHI ≥5/h, AHI ≥15/h, and AHI ≥30/h conditions.ResultsA total of 288 patients were enrolled in the study. For all severity OSA levels, the sensitivity of GOAL+NC ranged from 70.12 to 70.80%, and specificity ranged from 86.49 to 76.16%. The sensitivity of GOAL+NHR ranged from 73.31 to 81.75%, while specificity ranged from 83.78 to 70.86%. As for area under the curve (AUC) value under ROC curve, when AHI ≥5/h, compared with GOAL (0.806), No-Apnea (0.823), NoSAS (0.817), and GOAL+NC (0.815), GOAL+NHR (0.831) obtained the highest AUC value, but lower than STOP-Bang (0.837).ConclusionThe predictive power of incorporating NC or NHR into the GOAL questionnaire was significantly better than that of the GOAL itself. Furthermore, GOAL+NHR was superior to GOAL+NC in predicting OSA severity and better than the No-Apnea score and the NoSAS score.

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“…It consists of only 5 items, practically all of them are objective and it seems to be a very quick, easy and precise tool for prediction of OSA. In a different study, conduced on adult patients referred to the sleep center, the NoSAS showed a better discrimination capacity compared to the Berlin and STOP-Bang [68].…”

Section: Discussionmentioning

confidence: 85%

The Role of Screening Questionnaires in the Assessment of Risk and Severity of Obstructive Sleep apnea—Polysomnography Versus Polygraphy

MAŁOLEPSZA

Kudrycka

Karwowska

et al. 2021

Advances in Respiratory Medicine

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Obstructive sleep apnea (OSA) is a disease of significant importance, which may lead to numerous severe clinical consequences. The gold standard in the diagnosis of this sleep-related breathing disorder (SRBD) is polysomnography (PSG). However, due to the need for high expertise of staff who perform this procedure, its complexity, and relatively low availability, some simpler substitutes have been developed; among them is polygraphy (PG), which is most widely used. Also, there is a variety of questionnaires suitable to assess the pre-test probability and severity of OSA. The most frequently used ones are the STOP-BANG questionnaire (SBQ), NoSAS questionnaire, and Berlin questionnaire (BQ). However, they have different sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) when being used in various populations. The aim of this study is to provide a concise and clinically-oriented review of the most frequently used questionnaires, with special attention to its strengths and limitations. Moreover, we discuss whether PSG or PG would be more preferred for confirming OSA diagnosis with the highest likelihood.

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Comparison of NoSAS score with Berlin and STOP-BANG scores for sleep apnea detection in a clinical sample

Cited by 17 publications

References 14 publications

Obstructive sleep apnea and related symptoms in medical students

Obstructive sleep apnea and related symptoms in medical students

Incorporating neck circumference or neck-to-height ratio into the GOAL questionnaire to better detect and describe obstructive sleep apnea with application to clinical decisions

The Role of Screening Questionnaires in the Assessment of Risk and Severity of Obstructive Sleep apnea—Polysomnography Versus Polygraphy

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