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.
"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 . Therefore there is a mismatch in diagnostic accuracy between high sophisticated histological analysis and a questionnaire which just deals with clinical risk evaluation. "
"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.
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