From ESS to GPSS: Innovations in OSA Screening Tools Across Three Decades -A Comprehensive Update of Thirty-one Screening Questionnaires

Purpose of Review This paper comprehensively examines the evolution of OSA screening tools from 1991 to 2025 and evaluates their clinical applicability. Recent Findings Thirty-one screening tools have been developed over the last three decades (from the Epworth Sleepiness Scale (ESS) in the 1990’s to the General Practice Sleep Scale (GPSS) in 2025), varying in their structure, population base, and diagnostic thresholds. Earlier tools primarily targeted high-risk, clinic-based cohorts, while newer tools attempt to address limitations in sensitivity, inclusivity, and usability in general practice and community settings. Variability in definitions ( e.g. Apnoea/hypopnoea index (AHI) thresholds, symptom scoring) and population characteristics ( e.g. age, sex, ethnicity, comorbidities) impacts the performance and generalisability of existing tools. Summary No single OSA screening tool is universally applicable across diverse populations. While newer tools like the GPSS show promise by addressing demographic and clinical diversity, further validation in international and ethnically varied cohorts is needed.