{
  "abstract": "Background\n\nObstructive sleep apnea (OSA) is highly prevalent, and early identification remains a major public health challenge. The NoSAS score is a simple and validated screening tool, incorporating neck circumference >40 cm. However, neck circumference measurement may be inconsistently performed in routine practice. Patient-performed neck encirclement, an equipment-free hand-based maneuver, may represent a pragmatic alternative.Methods\n\nWe conducted a retrospective analysis of prospectively collected routine clinical data including 449 consecutive patients referred for suspected OSA in a tertiary sleep center (Lyon, France) between September and December 2025. Neck circumference and Patient-performed manual neck encirclement were assessed at the same anatomical level. Diagnostic performance was evaluated for apnea-hypopnea index (AHI) thresholds ≥15 and ≥30 events·h⁻¹. A modified NoSAS score incorporating patient-performed neck encirclement (NoSAS hand) was compared with the standard score. In paired complete-case comparisons, diagnostic estimates and between-score differences were reported with 95% confidence intervals and McNemar tests.Results\n\nPatient-performed neck encirclement was substantially more available than measured neck circumference (94.0% vs 71.3%) and NoSAS hand was calculable more often than standard NoSAS (91.3% vs 68.8%). In the paired complete-case cohort (n=305), at AHI ≥15/h, sensitivity and specificity differences (NoSAS hand minus standard NoSAS) were 0.0% (95% CI -1.9 to 1.9) and +1.0% (95% CI -2.0 to 5.1), respectively; corresponding differences at AHI ≥30/h were 0.0% (95% CI -2.5 to 2.5) and +0.5% (95% CI -1.6 to 2.7).Conclusions\n\nPatient-performed neck encirclement is a simple, equipment-free alternative to measured neck circumference that substantially improves the feasibility of NoSAS implementation while preserving diagnostic performance. In this tertiary sleep-centre workflow, patient-performed neck encirclement was recorded more often than measured neck circumference and increased NoSAS score availability; paired point estimates of sensitivity and specificity at AHI ≥15/h and ≥30/h differed little between scores.",
  "abstract_shown": true,
  "affiliations": [
    "Center for Sleep Medicine, Croix-Rousse Hospital, Hospices Civils De Lyon, Lyon, France.",
    "Division of Pulmonary Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.",
    "Center for Investigation and Research in Sleep, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.",
    "Lyon Neuroscience Research Center, PAM Team, INSERM U1028 / CNRS UMR 5292 / Lyon 1 University, Lyon, France.",
    "Grenoble Alpes University, HP2 Laboratory (Hypoxia Pathophysiology), INSERM U1300, Grenoble, France.",
    "Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon, Lyon, France."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Sarah Kassir"
    },
    {
      "affs": [
        1
      ],
      "name": "Claudio Rabec"
    },
    {
      "affs": [
        2
      ],
      "name": "Raphael Heinzer"
    },
    {
      "affs": [
        1
      ],
      "name": "Christophe Von Garnier"
    },
    {
      "affs": [
        0
      ],
      "name": "Lina Latreche"
    },
    {
      "affs": [
        0
      ],
      "name": "Sabrina Hajji"
    },
    {
      "affs": [
        0
      ],
      "name": "Francois Ricordeau"
    },
    {
      "affs": [
        0
      ],
      "name": "Emeric Stauffer"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Laure Peter-Derex",
      "orcid": "0000-0002-9938-9639"
    },
    {
      "affs": [
        0,
        4,
        5
      ],
      "name": "Pierre Tankéré"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cyda8bcqd986d.bib",
  "cited_by": 0,
  "doi": "10.2147/nss.s646897",
  "fulltext_url": "https://europepmc.org/articles/PMC13693516",
  "id": "cyda8bcqd986d",
  "issns": [
    "1179-1608"
  ],
  "landing_url": "https://europepmc.org/article/MED/42921212",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2737|Obstructive Sleep Apnea Research"
    ]
  ],
  "openalex": "W7222940413",
  "pdf_url": "https://europepmc.org/articles/PMC13693516?pdf=render",
  "pmcid": "PMC13693516",
  "pmid": "42921212",
  "published": "2026-10-19",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/cyda8bcqd986d.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:33Z",
      "native_id": "MED:42921212",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42921212"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Obstructive Sleep Apnea Research",
      "subfield": "physiology"
    }
  ],
  "title": "Patient-Performed Neck Encirclement Within the NoSAS Score: Score Availability and Diagnostic Performance in a Tertiary Sleep Centre.",
  "title_text": "Patient-Performed Neck Encirclement Within the NoSAS Score: Score Availability and Diagnostic Performance in a Tertiary Sleep Centre.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:33Z",
  "url": "https://research.draconitic.com/paper/cyda8bcqd986d",
  "venue": "Nature and science of sleep",
  "versions": []
}