title: Predictive value of Berlin Questionnaire and Epworth Sleepiness Scale for obstructive sleep apnea in a sleep clinic population.
abstract: BACKGROUND
  The Berlin Questionnaire (BQ) and Epworth Sleepiness Scale (ESS) are two of the widely used screening instruments for subjects suffering from sleep disorders.
  
  
  OBJECTIVE
  To determine the predictive accuracy of the BQ and ESS in the subjects who were admitted to our sleep clinic, using overnight polysomnography as the 'gold standard'.
  
  
  METHODS
  The BQ and ESS were performed to 1450 subjects hospitalized in our sleep clinic for polysomnographic evaluation.
  
  
  RESULTS
  One thousand two hundred thirty of 1450 subjects (84.8%) had apnea-hypopnea index (AHI) ≥ 5, and 70.5% of them were classified as being at high risk of sleep apnea with BQ and 45.9% of them were classified as having excessive daytime sleepiness with ESS. Being in the high-risk group with the self-reported, BQ predicted an AHI ≥ 5 with a sensitivity of 0.73 and a specificity of 0.44, vs a sensitivity of 0.46 and a specificity of 0.60 with the self-reported ESS. Sensitivity of BQ (0.80) was highest when we selected the cut-off value of AHI as 30. When we evaluated the predictive accuracy of BQ and ESS together, specificity of both instruments as 0.72 at AHI cut-off value of 5 was found. AHIs were significantly correlated with the scores in each category and the total scores of BQ (P < 0.0001).
  
  
  CONCLUSIONS
  The BQ is a poor predictor of obstructive sleep apnea (OSA) in subjects admitted to our sleep clinic. BQ and ESS together may be used to detect patients with low risk for OSA.
authors.affiliation: Department of Pulmonary Diseases, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey.
authors.forename: Sevinc Sarinc
authors.initials: SS
authors.lastname: Ulasli
authors.forename: Ersin
authors.initials: E
authors.lastname: Gunay
authors.forename: Tulay
authors.initials: T
authors.lastname: Koyuncu
authors.forename: Olcay
authors.initials: O
authors.lastname: Akar
authors.forename: Bilal
authors.initials: B
authors.lastname: Halici
authors.forename: Sena
authors.initials: S
authors.lastname: Ulu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Unlu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D017286:Polysomnography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Berlin Questionnaire; Epworth Sleepiness Scale; obstructive sleep apnea; sensitivity; specificity