PURPOSE: Many physicians have difficulty identifying patients at risk for sleep apnea. Obesity, snoring and daytime somnolence are recognized risk factors for sleep apnea. The Berlin questionnaire is a series of questions designed to identify patients with these risk factors. We prospectively studied the ability of the Berlin questionnaire to identify elderly patients with sleep apnea.
METHODS: The Berlin questionnaire was administered to 485 patients age ≥65 that subsequently underwent an overnight polysomnogram at a sleep laboratory. Significant sleep apnea was diagnosed by an apnea-hypopnea index of ≥15. Patient that were identified by the questionnaire as having at least 2 of these risk factors, were deemed high risk for sleep apnea.
RESULTS: Between April 2003 and May 2007, 485 patients with a mean age of 68.3 were studied. Four hundred and twelve (84%) of the patients were overweight with a BMI of ≥25, 257 (53%) experienced daytime somnolence, and 204 (42%) snored. Two hundred and four patients were identified as high risk; of these 184 patients (90%) had significant sleep apnea diagnosed by polysomnogrophy. The questionnaire demonstrated a sensitivity of 0.87, specificity of 0.90, and a positive predictive value of 0.89 for the diagnosis of significant sleep apnea. High-risk patients were 8 times more likely to have significant sleep apnea as compared to the low risk patients.
CONCLUSION: The Berlin questionnaire accurately identifies elderly patients at high risk for significant sleep apnea.
CLINICAL IMPLICATIONS: Obesity, snoring, and daytime somnolence are risk factors that can identify patients with sleep apnea.
DISCLOSURE: Adesoji Adenigbagbe, No Financial Disclosure Information; No Product/Research Disclosure Information