A Comparison of the Reliability of Five Sleep Questionnaires for the Detection of Obstructive Sleep Apnea
Status PubMed-not-MEDLINE Language English Country Switzerland Media electronic
Document type Journal Article
Grant support
00669806
Ministry of Health, Czech Republic - conceptual development of research organization, Faculty Hospital in Pilsen - FNPl
PubMed
36143452
PubMed Central
PMC9502623
DOI
10.3390/life12091416
PII: life12091416
Knihovny.cz E-resources
- Keywords
- Berlin questionnaire, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, STOP questionnaire, STOP-Bang questionnaire, obstructive sleep apnea,
- Publication type
- Journal Article MeSH
The aim of this study was to compare the reliability of five sleep questionnaires in detecting the occurrence of obstructive sleep apnea (OSA). The study was conducted on a group of 201 patients. The patients completed five sleep questionnaires: the Epworth Sleepiness Scale (ESS), the STOP-Bang questionnaire, the STOP questionnaire, the Berlin questionnaire (BQ) and the Pittsburgh Sleep Quality Index (PSQI). Subsequently, the patients were examined using limited polygraphy, and the sensitivity and specificity of the questionnaires were evaluated. The STOP-Bang, Berlin and STOP questionnaires had the highest sensitivity for OSA detection (81.6%, 78.7%, and 74.2%, respectively), while the sensitivities of PSQI and ESS were low (50.8% and 34.5%). The ESS, STOP-Bang, STOP and Berlin questionnaires had the highest specificity (82.6%, 75%, 61.9%, and 61.9%). In our sample, we found the STOP-Bang and Berlin questionnaires to be the most suitable for OSA screening with the highest sensitivities (81.6%, 78.7%) and satisfactory specificities (75%, 61.9%). The STOP questionnaire was also relatively reliable, especially given its time-saving nature; though short, it preserved satisfactory sensitivity (74.2%) and specificity (61.9%). The ESS and PSQI were unsuitable for OSA screening.
See more in PubMed
Garbarino S., Guglielmi O., Sanna A., Mancardi G.L., Magnavita N. Risk of Occupational Accidents in Workers with Obstructive Sleep Apnea: Systematic Review and Meta-analysis. Sleep. 2016;39:1211–1218. doi: 10.5665/sleep.5834. PubMed DOI PMC
Benjafield A.V., Ayas N.T., Eastwood P.R., Heinzer R., Ip M.S.M., Morrell M.J., Nunez C.M., Patel S.R., Penzel T., Pépin J.-L., et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: A literature-based analysis. Lancet Respir. Med. 2019;7:687–698. doi: 10.1016/S2213-2600(19)30198-5. PubMed DOI PMC
Deegan P., McNicholas W. Predictive value of clinical features for the obstructive sleep apnoea syndrome. Eur. Respir. J. 1996;9:117–124. doi: 10.1183/09031936.96.09010117. PubMed DOI
Crocker B.D., Olson L.G., Saunders N.A., Hensley M.J., McKeon J.L., Allen K.M., Gyulay S.G. Estimation of the Probability of Disturbed Breathing during Sleep before a Sleep Study. Am. Rev. Respir. Dis. 1990;142:14–18. doi: 10.1164/ajrccm/142.1.14. PubMed DOI
Viner S., Szalai J.P., Hoffstein V. Are History and Physical Examination a Good Screening Test for Sleep Apnea? Ann. Intern. Med. 1991;115:356. doi: 10.7326/0003-4819-115-5-356. PubMed DOI
Bliwise D.L., Nekich J.C., Dement W.C. Relative Validity of Self-Reported Snoring as a Symptom of Sleep Apnea in a Sleep Clinic Population. Chest. 1991;99:600–608. doi: 10.1378/chest.99.3.600. PubMed DOI
Slouka D., Kucera R., Gal B., Betka J., Skalova A.V. Biomarkers—A posibility for monitoring of obstructive sleep apnea syndrome. Neuro. Endocrinol. Lett. 2019;40:85–92. PubMed
Kump K., Whalen C., Tishler P.V., Browner I., Ferrette V., Strohl K.P., Rosenberg C., Redline S. Assessment of the validity and utility of a sleep-symptom questionnaire. Am. J. Respir. Crit. Care Med. 1994;150:735–7411. doi: 10.1164/ajrccm.150.3.8087345. PubMed DOI
Slouka D., Windrichova J., Rezackova H., Houfkova K., Kucera R., Cerna V., Kostlivy T., Topolcan O., Pesta M. The potential of miR-499 plasmatic level as a biomarker of obstructive sleep apnea syndrome. Biomarkers Med. 2021;15:1011–1019. doi: 10.2217/bmm-2020-0826. PubMed DOI
Lyons M.M., Kraemer J.F., Dhingra R., Keenan B.T., Wessel N., Glos M., Penzel T., Gurubhagavatula I. Screening for Obstructive Sleep Apnea in Commercial Drivers Using EKG-Derived Respiratory Power Index. J. Clin. Sleep Med. 2019;15:23–32. doi: 10.5664/jcsm.7562. PubMed DOI PMC
Johns M.W. A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale. Sleep. 1991;14:540–545. doi: 10.1093/sleep/14.6.540. PubMed DOI
Johns M.W. Sleepiness in Different Situations Measured by the Epworth Sleepiness Scale. Sleep. 1994;17:703–710. doi: 10.1093/sleep/17.8.703. PubMed DOI
Silva G.E., Vana K.D., Goodwin J.L., Sherrill D.L., Quan S.F. Identification of Patients with Sleep Disordered Breathing: Comparing the Four-Variable Screening Tool, STOP, STOP-Bang, and Epworth Sleepiness Scales. J. Clin. Sleep Med. 2011;7:467–472. doi: 10.5664/JCSM.1308. PubMed DOI PMC
Ulasli S.S., Gunay E., Koyuncu T., Akar O., Halici B., Ulu S., Unlu M. Predictive value of Berlin Questionnaire and Epworth Sleepiness Scale for obstructive sleep apnea in a sleep clinic population. Clin. Respir. J. 2014;8:292–296. doi: 10.1111/crj.12070. PubMed DOI
Rosenthal L.D., Dolan D.C. The Epworth Sleepiness Scale in the Identification of Obstructive Sleep Apnea. J. Nerv. Ment. Dis. 2008;196:429–431. doi: 10.1097/NMD.0b013e31816ff3bf. PubMed DOI
Shrestha S.K., Shrestha S., Rajkarnikar R., Malla J., Rayamajhi S., Bhattarai S., Sharma L., Bhusal Y. Comparing four standard Sleep Questionnaires to Polysomnography to predict possibility of Obstructive Sleep Apnea and its severity. J. Adv. Intern. Med. 2021;10:33–37. doi: 10.3126/jaim.v10i1.37089. DOI
Chung F., Yegneswaran B., Liao P., Chung S.A., Vairavanathan S., Islam S., Khajehdehi A., Shapiro C.M. STOP Questionnaire. Anesthesiology. 2008;108:812–821. doi: 10.1097/ALN.0b013e31816d83e4. PubMed DOI
Pivetta B., Chen L., Nagappa M., Saripella A., Waseem R., Englesakis M., Chung F. Use and Performance of the STOP-Bang Questionnaire for Obstructive Sleep Apnea Screening Across Geographic Regions. JAMA Netw. Open. 2021;4:e211009. doi: 10.1001/jamanetworkopen.2021.1009. PubMed DOI PMC
Costa J.C., Rebelo-Marques A., Machado J.P.N., Valentim B.M.F., Ferreira C.S.A.V., Gonçalves J.D.O., Gama J.M.D.R., Teixeira M.F.L., Moita J.J.M. STOP-Bang and NoSAS questionnaires as a screening tool for OSA: Which one is the best choice? Rev. Assoc. Med. Bras. 2020;66:1203–1209. doi: 10.1590/1806-9282.66.9.1203. PubMed DOI
Patel M.D., Tsang B.J., Saripella M.A., Nagappa M.M., Islam M.S., Englesakis M.M., Chung M.F. Validation of the STOP questionnaire as a screening tool for OSA among different populations: A systematic review and meta-regression analysis. J. Clin. Sleep Med. 2022;18:1441–1453. doi: 10.5664/jcsm.9820. PubMed DOI PMC
Netzer N.C., Stoohs R.A., Netzer C.M., Clark K., Strohl K.P. Using the Berlin Questionnaire to Identify Patients at Risk for the Sleep Apnea Syndrome. Ann. Intern. Med. 1999;131:485–491. doi: 10.7326/0003-4819-131-7-199910050-00002. PubMed DOI
Berlin questionnaire. Sleep Breath. 2000;4:99. doi: 10.1007/BF03045031. PubMed DOI
Karakoc O., Akcam T., Genc H., Yetkin S., Piskin B., Gerek M. Use of the Berlin Questionnaire to screen at-risk patients for obstructive sleep apnea. B-ENT. 2014;10:21–25. PubMed
Buysse D.J., Reynolds C.F., III, Monk T.H., Berman S.R., Kupfer D.J. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213. doi: 10.1016/0165-1781(89)90047-4. PubMed DOI
Scarlata S., Pedone C., Curcio G., Cortese L., Chiurco D., Fontana D., Calabrese M., Fusiello R., Abbruzzese G., Santangelo S., et al. Pre-polysomnographic assessment using the Pittsburgh Sleep Quality Index questionnaire is not useful in identifying people at higher risk for obstructive sleep apnea. J. Med Screen. 2013;20:220–226. doi: 10.1177/0969141313511591. PubMed DOI
Johns M.W. Reliability and Factor Analysis of the Epworth Sleepiness Scale. Sleep. 1992;15:376–381. doi: 10.1093/sleep/15.4.376. PubMed DOI
Johns M.W. Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale. Chest. 1993;103:30–36. doi: 10.1378/chest.103.1.30. PubMed DOI
Laub R.R., Mikkelsen K.L., Tønnesen P. Evaluation of the significance of Epworth sleepiness scale among 687 patients with suspected sleep apnea. Eur. Respir. J. Sep. 2015;46((Suppl. S59)) doi: 10.1183/13993003.congress-2015.PA2375. DOI
Mediano O., Barcelo A., de la Pena M., Gozal D., Agusti A., Barbe F. Daytime sleepiness and polysomnographic variables in sleep apnoea patients. Eur. Respir. J. 2007;30:110–113. doi: 10.1183/09031936.00009506. PubMed DOI
Chiu H.-Y., Chen P.-Y., Chuang L.-P., Chen N.-H., Tu Y.-K., Hsieh Y.-J., Wang Y.-C., Guilleminault C. Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: A bivariate meta-analysis. Sleep Med. Rev. 2017;36:57–70. doi: 10.1016/j.smrv.2016.10.004. PubMed DOI
Kee K., Dixon J., Shaw J., Vulikh E., Schlaich M., Kaye D.M., Zimmet P., Naughton M.T. Comparison of Commonly Used Questionnaires to Identify Obstructive Sleep Apnea in a High-Risk Population. J. Clin. Sleep Med. 2018;14:2057–2064. doi: 10.5664/jcsm.7536. PubMed DOI PMC
Abrishami A., Khajehdehi A., Chung F. A systematic review of screening questionnaires for obstructive sleep apnea. Can. J. Anaesth. 2010;57:423–438. doi: 10.1007/s12630-010-9280-x. PubMed DOI
Ahmadi N., Chung S.A., Gibbs A., Shapiro C.M. The Berlin questionnaire for sleep apnea in a sleep clinic population: Relationship to polysomnographic measurement of respiratory disturbance. Sleep Breath. 2007;12:39–45. doi: 10.1007/s11325-007-0125-y. PubMed DOI
Buysse D.J., Hall M.L., Strollo P.J., Kamarck T.W., Owens J., Lee L. Relationships between the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and clinical/polysomnographic measures in a community sample. J. Clin. Sleep Med. 2008;4:563–571. doi: 10.5664/jcsm.27351. Erratum in J. Clin. Sleep Med. 2010, 6, table of contents. PubMed DOI PMC
Carpenter J.S., Andrykowski M.A. Psychometric evaluation of the pittsburgh sleep quality index. J. Psychosom. Res. 1998;45:5–13. doi: 10.1016/S0022-3999(97)00298-5. PubMed DOI
Amado-Garzón S.B., Ruiz A.J., Rondón-Sepúlveda M.A., Hidalgo-Martínez P. Sensitivity and specificity of four screening sleep-disordered breathing tests in patients with and without cardiovascular disease. Sleep Sci. 2021;14:311–318. doi: 10.5935/1984-0063.20200104. PubMed DOI PMC