Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP: Using the Berlin questionnaire to identify patients at risk for the sleep apnea syndrome

Center for Sleep Education and Research, Case Western Reserve University, Cleveland, Ohio, USA.
Annals of internal medicine (Impact Factor: 17.81). 11/1999; 131(7):485-91. DOI: 10.7326/0003-4819-131-7-199910050-00041
Source: PubMed


Although sleep apnea is common, it often goes undiagnosed in primary care encounters.
To test the Berlin Questionnaire as a means of identifying patients with sleep apnea.
Survey followed by portable, unattended sleep studies in a subset of patients.
Five primary care sites in Cleveland, Ohio.
744 adults (of 1008 surveyed [74%]), of whom 100 underwent sleep studies.
Survey items addressed the presence and frequency of snoring behavior, waketime sleepiness or fatigue, and history of obesity or hypertension. Patients with persistent and frequent symptoms in any two of these three domains were considered to be at high risk for sleep apnea. Portable sleep monitoring was conducted to measure the number of respiratory events per hour in bed (respiratory disturbance index [RDI]).
Questions about symptoms demonstrated internal consistency (Cronbach correlations, 0.86 to 0.92). Of the 744 respondents, 279 (37.5%) were in a high-risk group that was defined a priori. For the 100 patients who underwent sleep studies, risk grouping was useful in prediction of the RDI. For example, being in the high-risk group predicted an RDI greater than 5 with a sensitivity of 0.86, a specificity of 0.77, a positive predictive value of 0.89, and a likelihood ratio of 3.79.
The Berlin Questionnaire provides a means of identifying patients who are likely to have sleep apnea.

46 Reads
  • Source
    • "In this context, we would like to give some comments: 1) As it is noted by the authors, they made a risk evaluation for the presence of OSAS using the Berlin questionnaire [2]. Therefore there is a mismatch in diagnostic accuracy between high sophisticated histological analysis and a questionnaire which just deals with clinical risk evaluation. "
  • Source
    • "Secondly, individuals who report snoring, frequent nocturnal awakenings with a feeling of dread or gasping for air, feeling un-refreshed upon awakening, or falling asleep or feeling tired during the day are at greater risk of OSA (Netzer et al., 1999). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Adult Obstructive Sleep Apnoea (OSA) is characterised by repeated, upper airway collapse resulting in sleep fragmentation and oxygen desaturation. Consequences of OSA include excessive daytime sleepiness, un-refreshing sleep, fatigue, increased risk of depression, reduced quality of life, and cognitive deficits. This article delineates the cognitive-and mood-related difficulties faced by individuals with OSA, discusses the theoretical accounts of nocturnal harm and daytime cognitive and mood dysfunction, and suggests practical tools to assess and treat psychological consequences of OSA.
    02/2015; 1(1). DOI:10.1037/tps0000021
  • Source
    • "The Berlin Questionnaire [12] was used to assess snoring and risk of SDB. Scores on this questionnaire range from 0 to 6; a positive Berlin was a score of ≥2. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study sought to characterize sleep patterns and sleep problems in a large sample of women across all months of pregnancy. A total of 2427 women completed an Internet-based survey that included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, vitality scale of the Short Form 36 Health Survey (SF-36), Insomnia Severity Index (ISI), Berlin questionnaire, International Restless Legs Syndrome (IRLS) question set, and a short version of the Pregnancy Symptoms Inventory (PSI). Across all months of pregnancy, women experienced poor sleep quality (76%), insufficient nighttime sleep (38%), and significant daytime sleepiness (49%). All women reported frequent nighttime awakenings (100%), and most women took daytime naps (78%). Symptoms of insomnia (57%), sleep-disordered breathing (19%), and restless legs syndrome (24%) were commonly endorsed, with no difference across the month of pregnancy for insomnia, sleep-disorder breathing, daytime sleepiness, or fatigue. In addition, high rates of pregnancy-related symptoms were found to disturb sleep, especially frequent urination (83%) and difficulty finding a comfortable sleep position (79%). Women experience significant sleep disruption, inadequate sleep, and high rates of symptoms of sleep disorder throughout pregnancy. These results suggest that all women should be screened and treated for sleep disturbances throughout pregnancy, especially given the impact of inadequate sleep and sleep disorders on fetal, pregnancy, and postpartum outcomes. Copyright © 2014 Elsevier B.V. All rights reserved.
    Sleep Medicine 01/2015; 16(4). DOI:10.1016/j.sleep.2014.12.006 · 3.15 Impact Factor
Show more