Screening Obstructive Sleep Apnea in Chinese Adults: Optimizing STOP-Bang and NoSAS Cutoff Values

BACKGROUND This retrospective study of 3129 individuals aimed to screen obstructive sleep apnea (OSA) with the modified STOP-Bang questionnaire (SBQ) and Neck, Obesity, Snoring, Age, Sex (NoSAS) scores, establish more appropriate cutoff values for these 2 questionnaires in Chinese patients, and investigate whether adding minimum oxygen saturation (LSpO2) as an item could improve the ability of these questionnaires. MATERIAL AND METHODS We collected polysomnography data, demographic data, anthropometric measurements, and the SBQ and NoSAS scores from 3129 participants. The ability of the SBQ and NoSAS score with different cutoff values to detect OSA was assessed. RESULTS In the SBQ, the area under the receiver operating characteristic curve (AUC) was maximized with the cutoff value of 4 in women, and the AUC values were 0.682 (apnea-hypopnea index [AHI] ³5/h), 0.680 (AHI ³15/h), and 0.694 (AHI v30/h). For men, with a cutoff value of 5, the AUCmax values were 0.655 (AHI ≥5/h), 0.632 (AHI ≥15/h), and 0.624(AHI ≥30/h). For women, the optimal NoSAS score cutoff values were 8 (AHI ≥5/h and AHI ≥15/h) and 10 (AHI ≥30/h), and the AUCmax values were 0.687, 0.649, and 0.662. For men, the optimal NoSAS score cutoff value was 12, and the AUCmax values were 0.628, 0.618, and 0.626. When LSpO2 <85% was added as an item to these 2 questionnaires, all AUC values increased. CONCLUSIONS We recommend using new cutoff values in the SBQ and NoSAS scores in Chinese patients and adding LSpO2 <85% in these 2 questionnaires for predicting OSA.