Abstract
BackgroundObstructive sleep apnea syndrome (OSAS) is a common disorder with significant morbidity and mortality. We aimed to evaluate the predictive accuracy of the Berlin questionnaire in patients with suspected OSAS undergoing PSG in the sleep laboratory setting against those going through the Embletta™ portable diagnostic system (Embletta PDS) at home.MethodsPatients with suspected OSAS were recruited from respiratory clinics to complete Berlin questionnaire and Epworth Sleepiness Score (ESS). Patients were randomized to undergo either home-based sleep test (group A) or hospital-based polysomnography (PSG) (group B).ResultsThree hundreds and sixteen subjects with newly referred suspected OSAS were recruited and randomized into group A (n = 157) and group B (n = 159). The prevalence of moderate to severe OSAS defined as apnea-hypopnea index (AHI) ≥ 15/h was 54%. The Berlin questionnaire identified 69.7% (n = 99) of subjects as high risk in group A and 77.5% (n = 100) in group B. The sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of the questionnaire to predict an AHI ≥ 15/h as diagnosed by PSG was 78, 23, 67 and 35%. When compared with Embletta PDS, the specificity and NPV increased to 48 and 63%. The area under the Receiver Operator Curve (ROC) based on PSG (AUC = 0.539, 95%CI 0.417, 0.661) and based on home Embletta (AUC = 0.712, 95%CI 0.617, 0.907).ConclusionsThe questionnaire was not reliable in predicting OSAS through PSG AHI whereas there was some predictive ability in discriminating patients with OSAS from normal subjects based on home Embletta sleep test.Trial registrationThe study was registered at ClinicalTrials.gov (Identifier: NCT01828216) on 10 April 2013.
Highlights
Obstructive sleep apnea syndrome (OSAS) is a common disorder with significant morbidity and mortality
Berlin questionnaire has been developed as a tool in screening OSAS and validated in primary care [13]
This study aimed to evaluate the accuracy of the Berlin questionnaire in patients with suspected OSAS in comparisons against PSG in the sleep laboratory setting and the EmblettaTM portable diagnostic system (Embletta PDS) at home
Summary
Obstructive sleep apnea syndrome (OSAS) is a common disorder with significant morbidity and mortality. Obstructive sleep apnea syndrome (OSAS) is a common disorder with prevalence rates of at least 4% among the middle-aged male Caucasians and Hong Kong (HK) Chinese populations [1,2,3]. It is characterized by repetitive episodes of upper airway obstruction, causing intermittent hypoxia, sleep fragmentation, disabling daytime sleepiness, Ng et al Respiratory Research (2019) 20:40 relative lack of qualified sleep physicians. Berlin questionnaire has been developed as a tool in screening OSAS and validated in primary care [13]. While there is a growing use of portable home monitoring in diagnosing OSAS, the performance of this questionnaire against the portable monitoring devices and PSG is needed
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