The role of screening questionnaires in diagnosis of sleep-disordered breathing

Abstract

Background. The prevalence of sleep-disordered breathing varies from 9% to 24% in adult population and is higherin some somatic diseases contributing to the worse outcomes. Early diagnostics of sleep-disоrdered breathing (SDB) might be beneficial for the management of somatic diseases. Objective. To assess the predictive value of the routine screening tests for the SDB diagnostics. Design and methods. Target population included residents of St Petersburg, who participated in the epidemiological study ESSE-RF. Out of 1417 participants, 136 individuals signed informed consent for additional sleep evaluation. The following tools were used to assess the presence of SDB: questionnaire of sleep quality, Epworth sleepiness scale; Pittsburgh questionnaire. Full in-lab polysomnography (Embla N7000, Natus, USA) was performed in 49 subjects. Results. Based on polysomnography, SDB was diagnosed in 17 of 49 patients. When compared to objective data, predictive values for SDB detection was 1,28 (χ 2 = 1,67; p = 0,19) for the question about snoring; 3,9 (χ 2 = 6,4; p = 0,011) for the question about sleep apnea; 3,9 (χ 2 = 9,3; p = 0,002) for the high risk of sleep apnea defined by the Berlin questionnaire; 2,9 (χ2 = 3,3; p = 0,07) for complaints of snoring by the Pittsburgh questionnaire; 1,2 (χ 2 = 0,05; p = 0,8) for the question about napping; 1,2 (χ 2 = 1,4; p = 0,2) for excessive sleepiness and 7.0 (χ 2 = 4,93; p = 0,026) for moderate to severe daytime sleepiness assessed by the Epworth sleepiness scale. Conclusions. Self-reported (subjective) questionnaires aimed to the assessment of SDB, are suitable to define further diagnostic strategy. However, they cannot be used for the differential diagnosis.