Tan Adeline, Hong Yueheng, Tan Linda W L, van Dam Rob M, Cheung Yan Yi, Lee Chi-Hang
Department of Respiratory Medicine, Jurong Health Services, Ng Teng Fong General Hospital, 1 Jurong East Street 21, Singapore, 609606, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
Sleep Breath. 2017 Dec;21(4):1033-1038. doi: 10.1007/s11325-016-1455-4. Epub 2017 Jan 7.
The NoSAS score was developed to identify subjects at high risk of sleep-disordered breathing (SDB). We aimed to validate the NoSAS score in a multiethnic Asian cohort and compare its performance to the STOP-Bang and Berlin questionnaires.
A sample of 242 subjects selected from a population-based cohort in Singapore completed home-based sleep testing with an Embletta device (type 3 monitor). All subjects were given the STOP-Bang and Berlin questionnaires for self-administration prior to the sleep study. The NoSAS score was subsequently calculated based on available demographic data and Berlin questionnaire responses.
The prevalence of severe SDB, defined as an apnea-hypopnea index cutoff of ≥30 events/h, was 10.7%. The number of subjects who were classified as high risk by the NoSAS score and STOP-Bang and Berlin questionnaires were 76 (31.4%), 89 (36.8%), and 79 (32.6%), respectively. The sensitivity, specificity, and negative and positive predictive values of the NoSAS score to predict severe SDB were 69.2, 73.1, 95.2, and 23.7%, respectively. The STOP-Bang and Berlin questionnaires performed similarly to the NoSAS score, with area under the curve (AUC) values of all three questionnaires clustered around 0.682-0.748. Compared to the STOP-Bang (94.8%) and Berlin questionnaires (96.3%), the NoSAS score (95.2%) had equally high negative predictive value in ruling out severe SDB.
The NoSAS score performed similarly to the STOP-Bang and Berlin questionnaires in a multiethnic Asian cohort. All three questionnaires had high negative predictive values in ruling out severe SDB and may have utility as screening tools.
开发NoSAS评分以识别睡眠呼吸障碍（SDB）高危人群。我们旨在在一个多民族亚洲队列中验证NoSAS评分，并将其性能与STOP-Bang问卷和柏林问卷进行比较。
从新加坡一个基于人群的队列中选取242名受试者，使用Embletta设备（3型监测仪）完成家庭睡眠测试。在睡眠研究之前，所有受试者都被给予STOP-Bang问卷和柏林问卷进行自我填写。随后根据可用的人口统计学数据和柏林问卷的回答计算NoSAS评分。
严重SDB的患病率，定义为呼吸暂停低通气指数截断值≥30次/小时，为10.7%。被NoSAS评分、STOP-Bang问卷和柏林问卷分类为高危的受试者人数分别为76人（31.4%）、89人（36.8%）和79人（32.6%）。NoSAS评分预测严重SDB的敏感性、特异性、阴性和阳性预测值分别为69.2%、73.1%、95.2%和23.7%。STOP-Bang问卷和柏林问卷的表现与NoSAS评分相似，所有三份问卷的曲线下面积（AUC）值集中在0.682 - 0.748左右。与STOP-Bang问卷（94.8%）和柏林问卷（96.3%）相比，NoSAS评分（95.2%）在排除严重SDB方面具有同样高的阴性预测值。
在一个多民族亚洲队列中，NoSAS评分的表现与STOP-Bang问卷和柏林问卷相似。所有三份问卷在排除严重SDB方面都具有高阴性预测值，可能作为筛查工具。
