STOPBANG versus NOSAS in screening patients with severe obstructive sleep apnea.

INTRODUCTION

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.

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

METHOD: 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.

RESULTS

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%).

CONCLUSION

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.