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P31. NOSAS SCORE: WHAT ROLE IN SCREENING PATIENTS

WITH SEVERE OBSTRUCTIVE SLEEP APNEA?

SARA.TRIMECH, EMNA. BEN JEMIA, HEND. OUERTANI, SIWAR.REJEB, HAIFA. ZAIBI,
JIHEN. BEN AMAR

PNEUMOLOGY DEPARTMENT OF CHARLES NICOLLE HOSPITAL. TUNIS EL MANAR UNIVERSITY,
TUNIS MEDICAL FACULTY, TUNISIA

Introduction : Obstructive sleep apnea (OSA) is a prevalent sleep disorder
characterized by repeated upper airway obstruction during sleep, leading to
significant health risks if untreated. Early screening is essential for a better
management. Many scores have been validated as useful tools to identify patients
at risk of OSA among which the NoSAS score.
This study aimed to evaluate the diagnostic performance of the NoSAS
questionnaire in identifying severe OSA among patients with a confirmed OSA.

Methods : A cross-sectional study was conducted from January 2023 to June 2024,
targeting patients with a confirmed sleep disorder in Charles Nicolle University
Hospital of Tunis. All patients included were required to fulfill the NoSAS
questionnaire. According to the American Academy of Sleep Medicine (AASM) the
diagnosis and severity of OSA were classified based on the AHI. We divided patients
into two groups: G1 with severe OSA and G2 with mild to moderate OSA. NoSAS
score consists of a total of six items comprises neck circumference˃ 40 cm
(4points), BMI between 25-30kg/m2 (3 points), BMI ˃30kg/m2 (5points), snoring

(2points), age˃55 years (4points) and male sex (2points). A NoSAS score ≥8 is
suggestive of being at high risk for OSA.

Results : A total of 172 patients diagnosed with OSA a mean age at 57.4±13 years
were enrolled. OSA severity was classified as mild in 63 patients (36.6%), moderate
in 45 (26.2%), and severe in 64 patients (37.2%). NoSAS score was significantly higher
in patients with severe OSA (G1: 11.4 ± 2.7 vs G2: 10 ± 2.8; p= 0.001). NoSAS score
demonstrated a high discriminative value, with area under the curve (AUC) of 0.64
CI [0.56-0.73]. The sensitivity (Se) and specificity (Sp) of NoSAS score were
respectively, Se=34.8%, Sp=85.6%with a cut-off value of 12.

Conclusion : NoSAS score had shown its efficacy in detecting rapidly patients with
severe OSA leading to an early management and lesser complications in the short
and long term. However, updated versions incorporating emerging data may get rid
of the limitations and improve the effectiveness.

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