Background <p>One of the most common sleep disorders affecting daily life is obstructive sleep apnoea (OSA). Polysomnography is the gold standard, but it is time-consuming, labour-intensive, expensive, requires high technical expertise and has long waiting times for tests.</p> Methods <p>From August 2023 to August 2024, a total of 147 participants met the requirements for inclusion in the study. Multivariate logistic regression analyses were performed to screen for independent risk factors for the development of OSA. This study aimed to construct the ROC curves of subjects used for the diagnosis of different degrees of OSA in different genders and to assess the AUC.</p> Results <p>A total of 89 (60.5%) participants were diagnosed with OSA. The AUCs of neck circumference (NC), US-guided attenuation parameter (UGAP), and NC + UGAP for diagnosing all OSA were 0.742 (95% CI 0.653–0.818), 0.666 (95% CI 0.573–0.750), and 0.765 (95% CI 0.678–0.838), respectively. The joint diagnosis of NC and UGAP has the highest value, especially for severe OSA in females.</p> Conclusions <p>The combined application of NC (response to anatomical features) and UGAP (response to metabolic features) is an effective screening tool for OSA in adult overweight/obese patients, especially for women with severe OSA. Future studies should focus on the application of this combined index for screening for early diagnosis and intervention of OSA.</p>