Using the Berlin Questionnaire to Identify Patients at Risk for the Sleep Apnea Syndrome
ABSTRACT 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.
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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
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ABSTRACT: Objective To examine the association between sleep duration and cardiometabolic risk factors among individuals with recently diagnosed type 2 diabetes (n=391). Methods Sleep duration was derived using a combination of questionnaire and objective heart rate and movement sensing in the UK ADDITION-Plus study (2002-2007). Adjusted means were estimated for individual cardiometabolic risk factors and clustered cardiometabolic risk (CCMR) by five categories of sleep duration. Results We observed a J-shaped association between sleep duration and CCMR – individuals sleeping 7-<8 hours had a significantly better CCMR profile than those sleeping ≥9 hours. Independent of physical activity and sedentary time, individuals sleeping 7-<8 hours had lower triacylglycerol (0.62 mmol/l [0.29, 1.06]) and higher HDL-cholesterol levels (0.23 mmol/l [0.16, 0.30]) compared with those sleeping ≥9 hours, and a lower waist circumference (7.87 cm [6.06, 9.68]) and BMI (3.47 kg/m2 [2.69, 4.25]) than those sleeping <6 hours. Although sleeping 7-<8 hours was associated with lower levels of systolic- and diastolic- blood pressure, HbA1c, total cholesterol and LDL-cholesterol, these associations were not statistically significant. Conclusions Sleep duration has a J-shaped association with CCMR in individuals with diabetes, independent of potential confounding. Health promotion interventions might highlight the importance of adequate sleep in this high risk population.Sleep Medicine 10/2014; 16(1). DOI:10.1016/j.sleep.2014.10.006 · 3.10 Impact Factor
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ABSTRACT: Objective To determine the association between objectively measured sleep and 10-year changes in estimated glomerular filtration rate (eGFR). Methods From 2003 to 2005, an ancillary sleep study was conducted at the Chicago site of the Coronary Artery Disease in Young Adults (CARDIA) study. Community-based black and white adults (aged 32–51 years) wore a wrist actigraph up to six nights to record sleep duration and fragmentation. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Participants without history of cardiovascular or chronic kidney diseases, proteinuria, or hypertension at the 2000–2001 CARDIA examination were followed over 10 years (n = 463). eGFR was estimated from serum creatinine (eGFRCr) at the 2000–2001, 2005–2006, and 2010–2011 CARDIA examinations, whereas cystatin-C-estimated eGFR (eGFRCys) was measured at the 2000–2001 and 2005–2006 examinations. Generalized estimating equation regression and linear models estimated the associations of each sleep parameter with changes in eGFRCr and eGFRCys, controlling for cardiovascular and renal risk. Results Sleep parameters were not related to 5-year change in eGFRCys. However, each 1 h decrease in sleep duration was significantly associated with a 1.5 mL/min/1.73 m2 higher eGFRCr [95% confidence interval (CI), 0.2−2.7], and each one-point increase in PSQI was significantly associated with a 0.5 mL/min/1.73 m2 higher eGFRCr (95% CI, 0.04−0.9) over 10 years. Conclusion In this community-based sample, shorter sleep and poorer sleep quality were related to higher kidney filtration rates over 10 years.Sleep Medicine 09/2014; DOI:10.1016/j.sleep.2014.05.021 · 3.10 Impact Factor