Research in context
Evidence before this study
Sleep-disordered breathing is a highly prevalent condition associated with neurocognitive deficits and increased cardiovascular risk. Diagnostic procedures, such as respiratory polygraphy or polysomnography, are time-consuming and expensive, so they cannot be used as routine screening for sleep-disordered breathing. We searched PubMed with the terms “sleep apnea”, “sleep apnoea”, and “screening score” up to Nov 30, 2015 (in English). We found that the most commonly used scores for sleep apnoea screening in clinical settings were the Berlin and the STOP-Bang scores. However, clinicians often complain about the complexity of the Berlin score and the high positive rate and lack of discrimination of the STOP BANG score. We thus aimed to develop a new screening score for sleep apnoea based on HypnoLaus, a large population-based sleep cohort.
Added value of this study
We propose a new simple clinical score (the NoSAS score) to screen for sleep-disordered breathing on the basis of clinical and polysomnographic data from a large population-based cohort. Using variables easily available in primary care practice, the NoSAS score allows identification of individuals at risk and ruling out of clinically significant sleep-disordered breathing, with an NPV of 90% and 98% in two ethnically different population-based cohorts.
Implications of all the available evidence
Compared with existing screening scores, the NoSAS score helps clinicians decide with a higher accuracy than at present which individuals should be referred for further testing, thereby reducing the number of missed sleep-disordered breathing diagnoses and unnecessary nocturnal recordings.