2023Archives of Internal Medicine ResearchOpen access

The Efficacy of the Berlin Questionnaire and the Epworth Sleepiness Scale in Obstructive Sleep Apnea

Ibrahim Güven Çosgun, Aydın Balcı

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Abstract

Background: Obstructive sleep apnea (OSA) is a disease in which apneahypopnea attacks occur during sleep and is characterized by a reduction in blood oxygen saturation during sleep. The gold standard diagnostic method is polysomnography (PSG).However, PSG is a time-consuming method that is expensive and requires special equipment, and care has to be taken in patient selection for PSG. The aim of this study was to evaluate the efficacy of the Epworth Sleepiness Scale (ESS) and the Berlin Questionnaire (BQ) in predicting OSA through comparisons with PSG. Materials and Methods: A retrospective examination was made of the records of patients who underwent one night PSG between September 2022 and December 2022, and the relationship of the BQ and ESS scores with the Apnea-Hypopnea Index (AHI) value determined in PSG was evaluated. Results: Evaluation was made of a total of 115 patients, comprising 77 (67%) males and 38 (33%) females. Ninety-nine of 115 subjects (86%) had AHI ≥ 5, and 85.5% of them were classified as being at high risk of sleep apnea with BQ and 54.9% of them were classified as having excessive daytime sleepiness with ESS. The consistency of the BQ and ESS for AHI ≥15 in OSA cases was determined to be 89.9% and 61.8%, respectively. Sensitivity of BQ (0.91) was highest when we selected the cut-off value of AHI as 30. Conclusion: The BQ was determined to be more effective than the ESS in the prediction of OSA diagnosis both in cases with AHI ≥5 and AHI≥15.

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Background: Obstructive sleep apnea (OSA) is a disease in which apneahypopnea attacks occur during sleep and is characterized by a reduction in blood oxygen saturation during sleep. The gold standard diagnostic method is polysomnography (PSG).However, PSG is a time-consuming method that is expensive and requires special equipment, and care has to be taken in patient selection for PSG. The aim of this study was to evaluate the efficacy of the Epworth Sleepiness Scale (ESS) and the Berlin Questionnaire (BQ) in predicting OSA through comparisons with PSG. Materials and Methods: A retrospective examination was made of the records of patients who underwent one night PSG between September 2022 and December 2022, and the relationship of the BQ and ESS scores with the Apnea-Hypopnea Index (AHI) value determined in PSG was evaluated. Results: Evaluation was made of a total of 115 patients, comprising 77 (67%) males and 38 (33%) females. Ninety-nine of 115 subjects (86%) had AHI ≥ 5, and 85.5% of them were classified as being at high risk of sleep apnea with BQ and 54.9% of them were classified as having excessive daytime sleepiness with ESS. The consistency of the BQ and ESS for AHI ≥15 in OSA cases was determined to be 89.9% and 61.8%, respectively. Sensitivity of BQ (0.91) was highest when we selected the cut-off value of AHI as 30. Conclusion: The BQ was determined to be more effective than the ESS in the prediction of OSA diagnosis both in cases with AHI ≥5 and AHI≥15.

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Available abstract

Background: Obstructive sleep apnea (OSA) is a disease in which apneahypopnea attacks occur during sleep and is characterized by a reduction in blood oxygen saturation during sleep. The gold standard diagnostic method is polysomnography (PSG).However, PSG is a time-consuming method that is expensive and requires special equipment, and care has to be taken in patient selection for PSG. The aim of this study was to evaluate the efficacy of the Epworth Sleepiness Scale (ESS) and the Berlin Questionnaire (BQ) in predicting OSA through comparisons with PSG. Materials and Methods: A retrospective examination was made of the records of patients who underwent one night PSG between September 2022 and December 2022, and the relationship of the BQ and ESS scores with the Apnea-Hypopnea Index (AHI) value determined in PSG was evaluated. Results: Evaluation was made of a total of 115 patients, comprising 77 (67%) males and 38 (33%) females. Ninety-nine of 115 subjects (86%) had AHI ≥ 5, and 85.5% of them were classified as being at high risk of sleep apnea with BQ and 54.9% of them were classified as having excessive daytime sleepiness with ESS. The consistency of the BQ and ESS for AHI ≥15 in OSA cases was determined to be 89.9% and 61.8%, respectively. Sensitivity of BQ (0.91) was highest when we selected the cut-off value of AHI as 30. Conclusion: The BQ was determined to be more effective than the ESS in the prediction of OSA diagnosis both in cases with AHI ≥5 and AHI≥15.

Key concepts: Epworth Sleepiness Scale, Polysomnography, Obstructive sleep apnea, Gold standard (test), Medicine, Sleep apnea, Sleep (system call), Physical therapy

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