A systematic review of screening questionnaires for obstructive sleep apnea
Open accessAbstract
Purpose Obstructive sleep apnea (OSA) may lead to life-threatening problems if it is left undiagnosed. Polysomnography is the "gold standard" for OSA diagnosis; however, it is expensive and not widely available. The objective of this systematic review is to identify and evaluate the available questionnaires for screening OSA.Source We carried out a literature search through MEDLINE, EMBASE, and CINAHL to identify eligible studies. The methodological validity of each study was assessed using the Cochrane Methods Group's guideline.Principal findings Ten studies (n = 1,484 patients) met the inclusion criteria. The Berlin questionnaire was the most common questionnaire (four studies) followed by the Wisconsin sleep questionnaire (two studies). Four studies were conducted exclusively on "sleep-disorder patients", and six studies were conducted on "patients without history of sleep disorders". For the first group, pooled sensitivity was 72.0% (95% confidence interval [CI]: 66.0-78.0%; I(2) = 23.0%) and pooled specificity was 61.0% (95% CI: 55.0-67.0%; I(2) = 43.8%). For the second group, pooled sensitivity was 77.0% (95% CI: 73.0-80.0%; I(2) = 78.1%) and pooled specificity was 53.0% (95% CI: 50-57%; I(2) = 88.8%). The risk of verification bias could not be eliminated in eight studies due to insufficient reporting. Studies on snoring, tiredness, observed apnea, and high blood pressure (STOP) and STOP including body mass index, age, neck circumference, gender (Bang) questionnaires had the highest methodological quality.Conclusion The existing evidence regarding the accuracy of OSA questionnaires is associated with promising but inconsistent results. This inconsistency could be due to studies with heterogeneous design (population, questionnaire type, validity). STOP and STOP-Bang questionnaires for screening of OSA in the surgical population are suggested due to their higher methodological quality and easy-to-use features.
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The NoSAS questionnaire has a sensitivity of 65%-90% in identifying sleep clinic patients with clinically relevant OSA.
“while the NoSAS has a sensitivity of 65%–90% in identifying sleep clinic patients with clinically relevant OSA.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [429]
The Results of accuracy outcomes section reports sensitivities for several screening questionnaires in sleep-disorder patients, but does not report a NoSAS result. Searches for “NoSAS” and “65%–90%” found no passage in our copy supporting the claimed sensitivity range for that questionnaire; the reported ranges concern other questionnaires. (LLM, conf=0.76)
Experimental — accuracy not yet measuredThere is very little evidence on the benefits of widespread screening for OSA in asymptomatic adults without comorbidities.
“There is very little evidence on the benefits of widespread screening for OSA in asymptomatic adults without comorbidities.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [429]
The Results and Discussion assess questionnaire accuracy in patients with and without known sleep problems, not the benefits of widespread screening in asymptomatic adults without comorbidities. A search for screening benefits in that population found no passage addressing the claim; the copy instead discusses possible benefits in surgical patients. (LLM, conf=0.75)
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- Authors
- Abrishami, A., Khajehdehi, A., & Chung, F.
- Affiliations
- University Health Network (CA)
- Corresponding author
- Chung, Frances
- Venue
- Canadian Journal of Anesthesia/Journal canadien d'anesthésie
- Published
- 2010-02-09
- Volume
- 57
- Issue
- 5
- Pages
- 423-438
- ISSN
- 0832-610X (ISSN-L)
- 1496-8975
- OpenAlex
- W1521879664
- Semantic Scholar
- 84df6efa00d893a067243e399238f1aed60510a9
- Cited by
- 581
- References
- 46
- Citations by year
- 2026: 13 · 2025: 26 · 2024: 21 · 2023: 18 · 2022: 40 · 2021: 26 · 2020: 38 · 2019: 40 · 2018: 58 · 2017: 34 · 2016: 53 · 2015: 69 · 2014: 37 · 2013: 38 · 2012: 42
- FWCI
- 3.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Canadian Journal of Anesthesia/Journal canadien d anesthésie (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Toronto
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- obstructive sleep apnea, OSA screening questionnaires, Berlin questionnaire, STOP questionnaire, STOP-BANG questionnaire, diagnostic accuracy, sensitivity and specificity, verification bias, snoring, hypertension, body mass index, neck circumference, surgical patients
- MeSH terms
- Adult, Female, Humans, Male, Mass Screening, Middle Aged, Surveys and Questionnaires, Research Design, Sensitivity and Specificity, Bias, Sleep Apnea, Obstructive
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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