Sleep apnea, screened
NoSAS score for sleep apnea
The NoSAS score is a short screen for sleep-disordered breathing, which includes sleep apnea. Its name lists its 5 items: Neck size, Obesity (BMI), Snoring, Age and Sex. Points add up to a score from 0 to 17, and 8 or more is the threshold its developers used to flag people at risk. It is a screening score, not a diagnosis.
Your answers
5 items. Nothing you enter leaves this page.
What you will see
Your NoSAS score out of 17, whether it reaches the 8-point threshold the developers used, and the points for each item.
Educational only, not medical advice. A screening score, not a diagnosis of sleep apnea.
Source
Marti-Soler H et al., Lancet Respiratory Medicine 2016. The points, the 0 to 17 range and the 8-point threshold are as printed in that paper's abstract, and match the reprint in Rong Y et al., Canadian Respiratory Journal 2020.
Validated in
Built in 2121 adults from the population-based HypnoLaus cohort in Lausanne, Switzerland, who had a sleep study (polysomnography) at home; checked in an independent sleep cohort (EPISONO).
Limits
A screening score, not a diagnosis. Only a sleep study can confirm sleep apnea. Built in a Swiss general population cohort, so it may work differently in other groups. Gives points for male sex and age over 55, so it may miss sleep-disordered breathing in younger people and in women.
How the NoSAS score is scored
The score runs from 0 to 17 (Marti-Soler 2016). The points are:
| Item | Scores points when | Points |
|---|---|---|
| Neck | Neck circumference more than 40 cm (about 15.7 in) | 4 |
| Obesity | BMI 25 to under 30 / BMI 30 or more | 3 / 5 |
| Snoring | You snore | 2 |
| Age | Older than 55 | 4 |
| Sex | Male | 2 |
A total of 8 points or more is the threshold the developers used to identify people at risk of clinically significant sleep-disordered breathing (Marti-Soler 2016). A later validation study reprints the same points and threshold (Rong 2020). We work out BMI from your height and weight (weight in kg divided by height in meters squared).
How well it worked
In the HypnoLaus cohort, the NoSAS score at 8 points or more had an area under the curve (AUC) of 0.74; in the independent EPISONO cohort the AUC was 0.81 (Marti-Soler 2016). AUC measures how well a score separates people with and without the condition: 0.5 is no better than chance and 1.0 is perfect. In HypnoLaus the NoSAS score did better than STOP-Bang (AUC 0.67) and the Berlin questionnaire (AUC 0.63) (Marti-Soler 2016). That comparison comes from the NoSAS developers' own study; results in other groups can differ.
NoSAS and STOP-Bang
Both scores use neck size, BMI, snoring, age and sex. STOP-Bang also asks about daytime tiredness, breathing pauses someone else has seen and high blood pressure, and it was built in people about to have surgery (Chung 2008) (Chung 2016). NoSAS was built in a general population cohort and needs no questions about symptoms other than snoring (Marti-Soler 2016). Read about STOP-Bang on our sleep apnea risk page.
What to do next
Common signs of sleep apnea include loud snoring, gasping or choking at night, and feeling very sleepy during the day (NHLBI). If you have these, tell your doctor; a home or lab sleep study can confirm it, and treatment helps (NHLBI). For adults without symptoms, the US Preventive Services Task Force found too little evidence to recommend screening (USPSTF 2022). A low NoSAS score does not rule out sleep apnea if you have symptoms.
Sources
- Marti-Soler H, Hirotsu C, Marques-Vidal P, et al. The NoSAS score for screening of sleep-disordered breathing: a derivation and validation study. Lancet Respir Med. 2016;4(9):742-748. doi:10.1016/S2213-2600(16)30075-3. PMID 27321086. (Origin of the NoSAS score; its abstract prints every point value, the 0 to 17 range and the 8-point threshold.) pubmed.ncbi.nlm.nih.gov/27321086/
- Rong Y, Wang S, Wang H, et al. Validation of the NoSAS Score for the Screening of Sleep-Disordered Breathing in a Sleep Clinic. Can Respir J. 2020;2020:4936423. doi:10.1155/2020/4936423. PMC6977329. (Reprints the NoSAS points and the 8-point threshold in its Methods, matching the original abstract.) pmc.ncbi.nlm.nih.gov/articles/PMC6977329/
- Chung F, Yegneswaran B, Liao P, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008;108(5):812-821. doi.org/10.1097/ALN.0b013e31816d83e4
- Chung F, Abdullah HR, Liao P. STOP-Bang Questionnaire: A Practical Approach to Screen for Obstructive Sleep Apnea. Chest. 2016;149(3):631-638. doi.org/10.1378/chest.15-0903
- National Heart, Lung, and Blood Institute (NIH). Sleep Apnea. www.nhlbi.nih.gov/health/sleep-apnea
- US Preventive Services Task Force. Screening for Obstructive Sleep Apnea in Adults: Recommendation Statement. JAMA. 2022;328(19):1945-1950. www.uspreventiveservicestaskforce.org/uspstf/recommendation/obstructive-sleep-apnea-in-adults-screening
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-01. Spotted an error? See About.