title: The effect of adding gender item to Berlin Questionnaire in determining obstructive sleep apnea in sleep clinics.
abstract: OBJECTIVE
  We aimed to validate the Turkish version of Berlin Questionnaire (BQ) and developped a BQ-gender (BQ-G) form by adding gender component. We aimed to compare the two forms in defining patients with moderate to severe obstructive sleep apnea (OSA) in sleep clinics.
  
  
  METHODS
  Four hundred and eighty five consecutive patients, refered to our sleep clinic for snoring, witnessed apnea and/or excessive daytime sleepiness were enrolled to the study. All patients underwent in-laboratory polysomnography (PSG). Patients with sleep efficiency less than 40% and total sleep time less than 4 hours, chronic anxiolitic/sedative drug usage, respiratory tract infection within past two weeks were excluded from the study. All the patients fulfilled BQ. The test and retest for BQ were applied in 15-day interval in 30 patients.
  
  
  RESULTS
  Totally 433 patients were enrolled to the study (285 male, 148 female). The mean age of the patients was 47,5 ± 10.5 (21-79). 180 patients (41.6%) had apnea-hypopnea index (AHI) ≤ 15, while 253 patients (58,4%) had AHI > 15. The κ value was 48-94 and the the truth value was 69-94% for the test-retest procedure. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and area under the curve AUC were 84.2%, 31.7%, 48.7%, 63.4%, and 0.579 in order for BQ and 79.9 %, 51.7%, 63.2% , 69.6%, and 0.652 for BQ-G.
  
  
  CONCLUSIONS
  The results showed that BQ-G is relatively better than BQ in determining moderate to severe OSA in sleep clinics where most of the patients are sleep apneic but both of the tests were found to have insufficient validities in defining moderate to severe OSA in sleep clinics.
authors.affiliation: Department of Chest Diseases and Sleep Center, Ankara Dıskapı Yıldırım Beyazıt Educational and Research Hospital, Ankara, Turkey.
authors.forename: Melike
authors.initials: M
authors.lastname: Yüceege
authors.affiliation: Department of Chest Diseases and Sleep Center, Ankara Dıskapı Yıldırım Beyazıt Educational and Research Hospital, Ankara, Turkey.
authors.forename: Hikmet
authors.initials: H
authors.lastname: Fırat
authors.affiliation: Department of Chest Diseases, Faculty of Medicine, Başkent University, Kars, Turkey.
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Sever
authors.affiliation: Faculty of Medicine, Hacettepe University, Kars, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Demir
authors.affiliation: Faculty of Medicine, Kafkas University, Kars, Turkey.
authors.forename: Sadık
authors.initials: S
authors.lastname: Ardıç
keywords: Berlin questionnaire; Breathing sleep disorder; gender; sleep apnea