Validation and diagnostic performance of the novel B‐ APNEIC score for predicting severe obstructive sleep apnoea: a cross‐sectional study in an Australian population

Summary Introduction The STOP‐BANG questionnaire assesses the peri‐operative risk of obstructive sleep apnoea and relies on subjective components, which limit its reliability. The B‐APNEIC score was proposed as a more objective alternative, incorporating just four STOP‐BANG variables: BMI > 35 kg.m ‐2 ; arterial blood pressure; neck circumference > 40 cm; and witnessed breathing interruptions. This study aimed to evaluate the predictive performance of the B‐APNEIC score in an Australian sleep clinic population. These findings would have important implications for use in the pre‐operative screening of obstructive sleep apnoea. Methods We enrolled participants referred for overnight diagnostic polysomnography. The STOP‐BANG questionnaire was administered and the B‐APNEIC score was extracted. The primary outcome was the predictive ability of a B‐APNEIC score ≥ 3 to detect severe obstructive sleep apnoea. Performance metrics were compared with a STOP‐BANG score ≥ 5. Results Among 274 patients, the B‐APNEIC score showed a sensitivity of 84% (95%CI 75–90%), specificity of 60% (95%CI 52–67%), positive predictive value of 56% (95%CI 48–64%) and negative predictive value of 86% (95%CI 78–91%) for predicting severe obstructive sleep apnoea. Compared with the STOP‐BANG score, the B‐APNEIC score showed superior sensitivity (84% vs. 73%); positive predictive value (56% vs. 52%); negative predictive value (86% vs. 78%); Youden Index (0.43 vs. 0.32); and area under the receiver operating characteristic curve (0.72 (95%CI 0.66–0.77) vs. 0.66 (95%CI 0.60–0.72); p = 0.02). Both scores had similar specificity (59%). Discussion The B‐APNEIC score showed strong predictive accuracy for severe obstructive sleep apnoea and could serve as a simple, objective alternative to STOP‐BANG. While further validation in surgical populations is warranted, these findings support its use in pre‐operative screening for obstructive sleep apnoea.