BACKGROUND The availability of poly(somno)graphy [P(S)G] for sleep apnea (SA) diagnosis is limited, making pre-test case evaluation an important challenge. The Neck, Obesity, Snoring, Age, Sex (NoSAS) and STOP-Bang (SBQ) scores are accepted screening tests, but their sex-specific performance in the general population is unknown. OBJECTIVE To compare the sex-specific diagnostic characteristics of the NoSAS and SBQ scores, and to optimize the performance of these tools for men and women. METHODS Participants from a population-based cohort (n = 2205) underwent clinical evaluation, including NoSAS, SBQ, and home polygraphy. RESULTS We obtained successful polygraphy in 1809 participants. Moderate-to-severe SA was present in 11.7%. Diagnostic performance indices of NoSAS and the SBQ calculated on the overall group (men + women) overestimated the performance in both sexes separately. The sensitivity of NoSAS for an apnea/hypopnea index (AHI) ≥15 h-1 was acceptable in men (87.1%), but low in women (55.3%). The reverse was true for the specificity (39.9% in men, 87.4% in women). A similar sex-specific difference in diagnostic performance was seen with the SBQ. Using women-specific cut-offs for the scores (NoSAS ≥6 or SBQ ≥2) and neck circumference (>35 cm) increased the sensitivity in women to levels similar to men (88.5 and 87.2%). Although specificity decreased, it still remained higher than in men. CONCLUSION In women, the sensitivity of NoSAS and the SBQ is too low for SA screening in the general population. Sex-specific cut-offs reverse this imbalance and achieve test sensitivities in women similar to those in men, whilst still retaining higher specificities than in men. Sleep questionnaires performance reporting should be sex-stratified.

中文翻译：

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特定性别的睡眠呼吸暂停筛查调查表：缩小女性的表现差距。

背景技术用于睡眠呼吸暂停（SA）诊断的X线描记图[P（S）G]的可用性受到限制，这使得测试前病例评估成为一个重要的挑战。可以接受颈部，肥胖，打nor，年龄，性别（NoSAS）和STOP-Bang（SBQ）评分，但在一般人群中其性别特异性表现尚不明确。目的比较NoSAS和SBQ分数的针对性别的诊断特征，并优化这些工具对男性和女性的性能。方法来自一个基于人群的队列（n = 2205）的参与者接受了临床评估，包括NoSAS，SBQ和家庭测谎。结果我们在1809年的参与者中获得了成功的测谎。中度至重度SA占11.7％。在整个组（男性+女性）上计算出的NoSAS和SBQ的诊断性能指数分别高估了男女的性能。NoSAS对呼吸暂停/呼吸不足指数（AHI）≥15 h-1的敏感性在男性中可接受（87.1％），在女性中较低（55.3％）。特异性相反（男性为39.9％，女性为87.4％）。SBQ在诊断性能方面存在类似的性别差异。使用特定于女性的分值作为分数（NoSAS≥6或SBQ≥2）和颈围（> 35 cm）可以将女性的敏感性提高到与男性相似的水平（88.5％和87.2％）。尽管特异性降低，但仍比男性高。结论在女性中，对于普通人群进行SA筛查，NoSAS和SBQ的敏感性太低。特定于性别的临界值可逆转这种不平衡，并在女性中获得与男性相似的测试敏感性，同时仍保留比男性更高的特异性。睡眠问卷的绩效报告应按性别分层。