title: Is the Berlin questionnaire a useful tool to diagnose obstructive sleep apnea in the elderly?
abstract: OBJECTIVE
  In the elderly, obstructive sleep apnea (OSA) is frequently under diagnosed. This study was undertaken to assess the accuracy of the Berlin questionnaire to diagnose OSA in a large healthy elderly population.
  
  
  METHODS
  Six hundred forty-three participants aged 65.6 years were examined. All subjects completed the Berlin questionnaire and underwent at-home respiratory recording. Presence of OSA was defined by an AHI>15.
  
  
  RESULTS
  Of the respondents, 202 subjects (31.4%) were in an OSA high-risk group according to the Berlin questionnaire. The high-risk subjects were significantly heavier, had greater waist and hip circumferences, higher AHI, and reported more frequently hypertension and diabetes. Habitual snoring was present in 54% of the sample, sleepiness in 12% of participants, and a BMI>30 and a history of hypertension in 42.1%. Being in the high-risk group predicted an AHI>15 with a sensitivity of 77%, a specificity of 39%, a positive predictive value of 63% and a negative predictive value of 55%. Among Berlin questionnaire categories, snoring correctly classified 61% of the sample and explained the 5% variance of AHI.
  
  
  CONCLUSIONS
  The Berlin questionnaire did not provide a high level of diagnostic specificity to discriminate OSA in an elderly population. Although not sufficiently accurate, this questionnaire can be used to identify subjects for sleep study assessment.
authors.affiliation: Service de Physiologie Clinique et de l'Exercice, CHU Nord, Saint-Etienne, Faculté de Médecine Jacques Lisfranc, PRES Université de Lyon 42023, Université Jean Monnet, Saint-Etienne, France. e.sforza@yahoo.fr
authors.forename: Emilia
authors.initials: E
authors.lastname: Sforza
authors.forename: Florian
authors.initials: F
authors.lastname: Chouchou
authors.forename: Vincent
authors.initials: V
authors.lastname: Pichot
authors.forename: François
authors.initials: F
authors.lastname: Herrmann
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Barthélémy
authors.forename: Frédéric
authors.initials: F
authors.lastname: Roche
mesh_terms: D000368:Aged; D000375:Aging; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D012913:Snoring / Q000175:diagnosis / Q000453:epidemiology; D011795:Surveys and Questionnaires / Q000592:standards*