PURPOSE: The purpose of this study is to test the validity of the Berlin questionnaire and evaluate its usefulness in Korean population.
METHODS: This is a retrospective study of 80 individuals who visited our sleep clinic. The subject’s demographics, Berlin questionnaire scores, apnea-hyponea index (AHI)and sleep study parameters were reviewed. All subjects completed the overnight polysomnography between February 2009 and August 2010.
RESULTS: Of the 80 subjects, there were 19 subjects with simple snoring and 61 subjects with obstructive sleep apnea (20 mild, 17 moderate, 24 severe). Males compromised 76.3% (n=61). The mean age and body mass index (BMI) were: 48.8 years and 25.6 kg/m2, respectively. There was a relationship between AHI and BMI (r=0.466, p<0.001). Seventy five (93.8%), 38 (47.5%), and 35 (43.8%) scored positively in categories 1, 2, and 3. The Berlin questionnaire identified 55 patients (68.8%) as being at high-risk of having sleep apnea. But in this group, 44 (80%) had OSA, and 11 (20%) were simple snorers. Of the low-risk group in the Berlin questionnaire, 17 (68%) patients had OSA, and 8 (32%) were simple snorers. The high risk group showed lower mean and minimal oxygen saturation compared to low risk group. The Berlin questionnaire performed with 72.1% sensitivity and 42.1% specificity at the AHI>5 level. There was no statistical association between OSA and the findings of the Berlin questionnaire. There was a moderate association between the severity of OSA and category 1 (p=0.015), and also category 2 (p=0.006).
CONCLUSIONS: Category 1 and 2 of the Berlin questionnaire showed correlation with the severity of OSA. Because of the low sensitivity and specificity, the Berlin questionnaire is not an appropriate tool for identifying patients with sleep apnea in a sleep clinic.
CLINICAL IMPLICATIONS: The findings of this study suggest alternative ways through which the sensitivity and specificity of the Berlin questionnaire can be improved. Further studies are needed to validate the Berlin questionnaire before use in the clinical setting in Korean population.
DISCLOSURE: The following authors have nothing to disclose: Hyeon Hui Kang, Chan Kwon Park, Ji Young Kang, Ju Sang Kim, Myung Sook Kim, Rhee Chin Kook, Sung Kyoung Kim, Ki Hoon Park
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