Design and Validation of Sleep Apnea Risk Assessment (SARA): A Screening Tool for Moderate-to-Severe Obstructive Sleep Apnea

Sarka Solecka,1– 3 Hana Tomaskova,3 Milos Chudy,3,4 Tomas Kostlivy,5 Jana Slonkova4,6 1Department of Otorhinolaryngology, St Luke’s Hospital, Bielsko-Biala, 43-309, Poland; 2Department of Otorhinolaryngology, Hospital in Frýdek-Místek, Frýdek-Místek, 738 01, Czech Republic; 3Department of Epidemiolo...

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Main Authors: Solecka S, Tomaskova H, Chudy M, Kostlivy T, Slonkova J
Format: Article
Language:English
Published: Dove Medical Press 2025-06-01
Series:Nature and Science of Sleep
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Online Access:https://www.dovepress.com/design-and-validation-of-sleep-apnea-risk-assessment-sara-a-screening--peer-reviewed-fulltext-article-NSS
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author Solecka S
Tomaskova H
Chudy M
Kostlivy T
Slonkova J
author_facet Solecka S
Tomaskova H
Chudy M
Kostlivy T
Slonkova J
author_sort Solecka S
collection DOAJ
description Sarka Solecka,1– 3 Hana Tomaskova,3 Milos Chudy,3,4 Tomas Kostlivy,5 Jana Slonkova4,6 1Department of Otorhinolaryngology, St Luke’s Hospital, Bielsko-Biala, 43-309, Poland; 2Department of Otorhinolaryngology, Hospital in Frýdek-Místek, Frýdek-Místek, 738 01, Czech Republic; 3Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, 70103, Czech Republic; 4Department of Neurology, University Hospital Ostrava, Ostrava- Poruba, 708 52, Czech Republic; 5Department of Otorhinolaryngology, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Pilsen, 301 00, Czech Republic; 6Department of Clinical Neurosciences, Faculty of Medicine, University of Ostrava, Ostrava, 703 00, Czech RepublicCorrespondence: Jana Slonkova, Department of Neurology, University Hospital Ostrava, 17. listopadu 1790, Ostrava- Poruba, 708 52, Czech Republic, Tel +420608742273, Email jana.slonkova@fno.czPurpose: We designed and validated a concise, efficient screening tool, the Sleep Apnea Risk Assessment (SARA), to identify patients at high risk of moderate to-severe obstructive sleep apnea.Patients and methods: We conducted a two-phase, multicenter study from September 1, 2018, to October 31, 2023. We created Cohort A (n=221, mean age 50.5± 13.0 years, 69.2% male) to design SARA and compared the results with the Epworth Sleepiness Scale, Berlin Questionnaire, Pittsburgh Sleep Quality Index, STOP-Bang, and STOP questionnaires. Cohort B (n=253, mean age 48.0± 13.4 years, 75.5% male) served for validation.Results: SARA comprises six variables with the highest accuracy: sleep apnea observed by the bedroom partner (8 points), snoring (5 points), male sex (3 points), age≥ 50 years (3 points), daytime fatigue (3 points), and body mass index≥ 30 kg/m2 (2 points). SARA yielded an area under the receiver operating characteristic curve (AUC) of 0.77 (95% CI: 0.71– 0.83) and sensitivity of 87.2% (95% CI: 80.8– 92.1) in cohort A at a cut-off score of ≥ 11 points. Validation in cohort B showed an AUC of 0.79 (95% CI: 0.74– 0.84) and a sensitivity of 98% (95% CI: 89.2– 95.4). SARA performance significantly outperformed the other questionnaires tested.Conclusion: The SARA is a promising new screening tool for moderate-to-severe obstructive sleep apnea, demonstrating high sensitivity and a strong ROC curve. Further large-scale validation is recommended.Keywords: Berlin questionnaire, Epworth sleepiness scale, obstructive sleep apnea, SARA, screening questionnaire, STOP-bang
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spelling doaj-art-b6eb2932a9fb440295b8d950cf8071812025-08-20T03:29:52ZengDove Medical PressNature and Science of Sleep1179-16082025-06-01Volume 17Issue 111631174103554Design and Validation of Sleep Apnea Risk Assessment (SARA): A Screening Tool for Moderate-to-Severe Obstructive Sleep ApneaSolecka S0Tomaskova H1Chudy M2Kostlivy T3Slonkova J4OtorhinolaryngologyDepartment of Epidemiology and Public HealthDepartment of Epidemiology and Public HealthDepartment of Otorhinolaryngology and Head and Neck SurgeryDepartment of Neurology and Department of Clinical NeurosciencesSarka Solecka,1– 3 Hana Tomaskova,3 Milos Chudy,3,4 Tomas Kostlivy,5 Jana Slonkova4,6 1Department of Otorhinolaryngology, St Luke’s Hospital, Bielsko-Biala, 43-309, Poland; 2Department of Otorhinolaryngology, Hospital in Frýdek-Místek, Frýdek-Místek, 738 01, Czech Republic; 3Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, 70103, Czech Republic; 4Department of Neurology, University Hospital Ostrava, Ostrava- Poruba, 708 52, Czech Republic; 5Department of Otorhinolaryngology, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Pilsen, 301 00, Czech Republic; 6Department of Clinical Neurosciences, Faculty of Medicine, University of Ostrava, Ostrava, 703 00, Czech RepublicCorrespondence: Jana Slonkova, Department of Neurology, University Hospital Ostrava, 17. listopadu 1790, Ostrava- Poruba, 708 52, Czech Republic, Tel +420608742273, Email jana.slonkova@fno.czPurpose: We designed and validated a concise, efficient screening tool, the Sleep Apnea Risk Assessment (SARA), to identify patients at high risk of moderate to-severe obstructive sleep apnea.Patients and methods: We conducted a two-phase, multicenter study from September 1, 2018, to October 31, 2023. We created Cohort A (n=221, mean age 50.5± 13.0 years, 69.2% male) to design SARA and compared the results with the Epworth Sleepiness Scale, Berlin Questionnaire, Pittsburgh Sleep Quality Index, STOP-Bang, and STOP questionnaires. Cohort B (n=253, mean age 48.0± 13.4 years, 75.5% male) served for validation.Results: SARA comprises six variables with the highest accuracy: sleep apnea observed by the bedroom partner (8 points), snoring (5 points), male sex (3 points), age≥ 50 years (3 points), daytime fatigue (3 points), and body mass index≥ 30 kg/m2 (2 points). SARA yielded an area under the receiver operating characteristic curve (AUC) of 0.77 (95% CI: 0.71– 0.83) and sensitivity of 87.2% (95% CI: 80.8– 92.1) in cohort A at a cut-off score of ≥ 11 points. Validation in cohort B showed an AUC of 0.79 (95% CI: 0.74– 0.84) and a sensitivity of 98% (95% CI: 89.2– 95.4). SARA performance significantly outperformed the other questionnaires tested.Conclusion: The SARA is a promising new screening tool for moderate-to-severe obstructive sleep apnea, demonstrating high sensitivity and a strong ROC curve. Further large-scale validation is recommended.Keywords: Berlin questionnaire, Epworth sleepiness scale, obstructive sleep apnea, SARA, screening questionnaire, STOP-banghttps://www.dovepress.com/design-and-validation-of-sleep-apnea-risk-assessment-sara-a-screening--peer-reviewed-fulltext-article-NSSBerlin QuestionnaireEpworth Sleepiness ScaleObstructive Sleep ApneaSARAScreening QuestionnaireSTOP-Bang;
spellingShingle Solecka S
Tomaskova H
Chudy M
Kostlivy T
Slonkova J
Design and Validation of Sleep Apnea Risk Assessment (SARA): A Screening Tool for Moderate-to-Severe Obstructive Sleep Apnea
Nature and Science of Sleep
Berlin Questionnaire
Epworth Sleepiness Scale
Obstructive Sleep Apnea
SARA
Screening Questionnaire
STOP-Bang;
title Design and Validation of Sleep Apnea Risk Assessment (SARA): A Screening Tool for Moderate-to-Severe Obstructive Sleep Apnea
title_full Design and Validation of Sleep Apnea Risk Assessment (SARA): A Screening Tool for Moderate-to-Severe Obstructive Sleep Apnea
title_fullStr Design and Validation of Sleep Apnea Risk Assessment (SARA): A Screening Tool for Moderate-to-Severe Obstructive Sleep Apnea
title_full_unstemmed Design and Validation of Sleep Apnea Risk Assessment (SARA): A Screening Tool for Moderate-to-Severe Obstructive Sleep Apnea
title_short Design and Validation of Sleep Apnea Risk Assessment (SARA): A Screening Tool for Moderate-to-Severe Obstructive Sleep Apnea
title_sort design and validation of sleep apnea risk assessment sara a screening tool for moderate to severe obstructive sleep apnea
topic Berlin Questionnaire
Epworth Sleepiness Scale
Obstructive Sleep Apnea
SARA
Screening Questionnaire
STOP-Bang;
url https://www.dovepress.com/design-and-validation-of-sleep-apnea-risk-assessment-sara-a-screening--peer-reviewed-fulltext-article-NSS
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