PURPOSE: The NoSAS score was developed to identify subjects at high risk of 
sleep-disordered breathing (SDB). We aimed to validate the NoSAS score in a 
multiethnic Asian cohort and compare its performance to the STOP-Bang and Berlin 
questionnaires.
METHODS: A sample of 242 subjects selected from a population-based cohort in 
Singapore completed home-based sleep testing with an Embletta device (type 3 
monitor). All subjects were given the STOP-Bang and Berlin questionnaires for 
self-administration prior to the sleep study. The NoSAS score was subsequently 
calculated based on available demographic data and Berlin questionnaire 
responses.
RESULTS: The prevalence of severe SDB, defined as an apnea-hypopnea index cutoff 
of ≥30 events/h, was 10.7%. The number of subjects who were classified as high 
risk by the NoSAS score and STOP-Bang and Berlin questionnaires were 76 (31.4%), 
89 (36.8%), and 79 (32.6%), respectively. The sensitivity, specificity, and 
negative and positive predictive values of the NoSAS score to predict severe SDB 
were 69.2, 73.1, 95.2, and 23.7%, respectively. The STOP-Bang and Berlin 
questionnaires performed similarly to the NoSAS score, with area under the curve 
(AUC) values of all three questionnaires clustered around 0.682-0.748. Compared 
to the STOP-Bang (94.8%) and Berlin questionnaires (96.3%), the NoSAS score 
(95.2%) had equally high negative predictive value in ruling out severe SDB.
CONCLUSIONS: The NoSAS score performed similarly to the STOP-Bang and Berlin 
questionnaires in a multiethnic Asian cohort. All three questionnaires had high 
negative predictive values in ruling out severe SDB and may have utility as 
screening tools.