{
  "abstract": "Background: Sleep questionnaires are widely used to screen for obstructive sleep apnea (OSA), but their incremental value beyond collecting basic demographics is rarely assessed. Using a large sample of sleep clinic intake questionnaire data that includes the Epworth Sleepiness Scale, questions on snoring and breathing pause as well as medical history data, we quantified questionnaire-item contributions relative to demographics for OSA severity classification. Methods: In a retrospective cohort of 67,397 adults referred for in-laboratory polysomnography and with questionnaire data, XGBoost classifiers were trained on all features (169 variables), questionnaire items only (161), or demographics only (age, gender, BMI, race; 4). Outcomes were the apnea-hypopnea index (AHI) and respiratory disturbance index (RDI) at 5, 15 and 30 events/h, evaluated on a held-out 10% test set; TabPFN v2.5 served as a secondary comparator. SHAP (SHapley Additive exPlanations) analysis was performed globally and within age and BMI strata; Berlin and STOP-Bang were not evaluated. Results: At AHI [≥] 5, [≥] 15 and [≥] 30, the demographics-only model reached area under the receiver operating characteristic curve (AUROC) 0.749, 0.718 and 0.726, 0.016-0.038 below the all-features model; across all six endpoints it retained 86-94% of the above-chance AUROC. The questionnaire-only model performed worst (AUROC 0.674-0.699 for AHI). Age, BMI and gender were the leading SHAP predictors at every threshold, and the contributions of age and BMI varied across strata. Four-class severity classification was poor (XGBoost accuracy [≤] 0.45). Conclusions: In this referred cohort, four demographic variables captured most of the achievable discrimination, and the questionnaire added at most 0.038 AUROC. Questionnaire-based screening tools should be benchmarked against a demographic baseline, and prospective validation is needed.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "name": "R. Patted"
    },
    {
      "name": "M. Dige"
    },
    {
      "name": "U. Hanif"
    },
    {
      "affs": [
        0
      ],
      "name": "E. Mignot"
    },
    {
      "name": "G. Ricciardiello Mejia"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9r1mgwn26e2hj.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.11.01.26367019",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.11.01.26367019v1.full",
  "id": "9r1mgwn26e2hj",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.11.01.26367019v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "respiratory medicine"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.11.01.26367019v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/9r1mgwn26e2hj.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T12:20:20Z",
      "native_id": "10.64898/2026.11.01.26367019",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.11.01.26367019v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:respiratory medicine",
      "subfield": "general"
    }
  ],
  "title": "Do Sleep Questionnaires Add Predictive Value Beyond Demographics for Obstructive Sleep Apnea Severity? Evidence from 67,397 Patients",
  "title_text": "Do Sleep Questionnaires Add Predictive Value Beyond Demographics for Obstructive Sleep Apnea Severity? Evidence from 67,397 Patients",
  "type": "preprint",
  "updated_at": "2026-11-04T00:21:02Z",
  "url": "https://research.draconitic.com/paper/9r1mgwn26e2hj",
  "venue": "medRxiv",
  "versions": []
}