title: Findings of a Berlin Questionnaire survey: comparison between patients seen in an asthma clinic versus internal medicine clinic.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) and asthma are common and share similar nocturnal symptoms. We hypothesized that the prevalence of OSA symptoms would be greater in asthmatics compared to a general internal medicine population.
  
  
  METHODS
  Patients in the Asthma Clinics (n=177) and Internal Medicine Clinics (n=328) at MetroHealth Medical Center, an urban academic institution, were surveyed for OSA risk. Patients completed the Berlin Questionnaire, a validated questionnaire with a positive predictive value (ppv) of 0.89 for determining the presence of OSA in primary care populations. All asthmatics had spirometry performed.
  
  
  RESULTS
  The asthma group had more females (p=0.01) and a higher mean body mass index (33.2 vs. 31.2 kg/m(2), p=0.02). However, the percentage with a body mass index >30 kg/m(2) was not different between the groups (p=0.19). The internal medicine group had a much higher rate of hypertension (p=0.002) and diabetes (p<0.001). Asthmatics were more likely to report frequent snoring (18.5% vs. 8.0%, p<0.001) and chronic sleepiness (46.1% vs. 34.3%, p=0.01). OSA risk, as determined by the Berlin Questionnaire, was higher in the asthma group than in the internal medicine group (39.5% vs. 27.2%, p=0.004). In the asthma group, risk for OSA did not correlate with asthma severity (p=0.183).
  
  
  CONCLUSIONS
  This study suggests a possible association between asthma and OSA. There is a higher prevalence of OSA symptoms in an asthmatic population when compared to a primary care population, independent of the severity of the asthma.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, MetroHealth Medical Center, Case Western Reserve University, Bell-Greve 3-90, 2500 MetroHealth Drive, Cleveland, OH 44109, USA. dauckley@metrohealth.org
authors.forename: Dennis
authors.initials: D
authors.lastname: Auckley
authors.forename: Moayyed
authors.initials: M
authors.lastname: Moallem
authors.forename: Ziad
authors.initials: Z
authors.lastname: Shaman
authors.forename: Masroor
authors.initials: M
authors.lastname: Mustafa
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008511:Medicine; D008875:Middle Aged; D009820:Ohio; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D011320:Primary Health Care; D011446:Prospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D013038:Specialization; D011795:Surveys and Questionnaires