title: The Berlin questionnaire screens for obstructive sleep apnea in idiopathic intracranial hypertension.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) may be associated with idiopathic intracranial hypertension (IIH), a disorder most commonly occurring in young obese women. Because polysomnography, the standard test for diagnosing OSA, is expensive and time consuming, questionnaires have been developed to identify persons with OSA. The Berlin questionnaire (BQ) reliably identifies middle-aged and older persons in the community who are at high-risk for OSA. We aimed to validate the BQ as a screening tool for OSA in IIH patients.
  
  
  METHODS
  Patients with newly diagnosed IIH completed the BQ and then underwent diagnostic polysomnography. The BQ was scored as high or low risk for OSA, and the diagnosis of OSA was based on polysomnography findings. OSA was defined as an apnea-hypopnea index of ≥ 5 on polysomnography.
  
  
  RESULTS
  Thirty patients were evaluated (24 women; 15 white and 15 black; age, 16-54 years [median, 32 years]; body mass index, 27.3-51.7 kg/m2 [median, 39.8 kg/m2]). Twenty patients (66.7%) had a high-risk BQ score and 18 (60%) exhibited OSA. Fifteen of 20 (75%) with a high-risk BQ score had OSA, while 3 of 10 (30%) with a low-risk score had OSA (Fisher test, P = 0.045). The sensitivity and specificity of the BQ for OSA in IIH patients were 83% and 58%, respectively, whereas the positive predictive value was 75%.
  
  
  CONCLUSIONS
  A low-risk BQ score identifies IIH patients who are unlikely to have OSA. Polysomnography should be considered in those with a high-risk score.
authors.affiliation: Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Thurtell
authors.forename: Beau B
authors.initials: BB
authors.lastname: Bruce
authors.forename: David B
authors.initials: DB
authors.lastname: Rye
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Newman
authors.forename: Valerie
authors.initials: V
authors.lastname: Biousse
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011237:Predictive Value of Tests; D011559:Pseudotumor Cerebri / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D055815:Young Adult