PURPOSE: 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.

Department of Clinical Neurosciences Faculty of Medicine University of Ostrava Ostrava 703 00 Czech Republic

Department of Epidemiology and Public Health Faculty of Medicine University of Ostrava Ostrava 70103 Czech Republic

Department of Neurology University Hospital Ostrava Ostrava Poruba 708 52 Czech Republic

Department of Otorhinolaryngology Hospital in Frýdek Místek Frýdek Místek 738 01 Czech Republic

Department of Otorhinolaryngology St Luke's Hospital Bielsko Biala 43 309 Poland

Department of Otorhinolaryngology University Hospital in Pilsen Faculty of Medicine in Pilsen Charles University Pilsen 301 00 Czech Republic

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