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Using a Questionnaire to Help Identify Patients with Sleep Apnea FREE

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The summary below is from the full report titled “Using the Berlin Questionnaire To Identify Patients at Risk for the Sleep Apnea Syndrome.” It is in the 5 October 1999 issue of Annals of Internal Medicine (volume 131, pages 485-491). The authors are N.C. Netzer, R.A. Stoohs, C.M. Netzer, K. Clark, and K.P. Strohl.

Ann Intern Med. 1999;131(7):485. doi:10.7326/0003-4819-131-7-199910050-00041
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What is the problem and what is known about it so far?

People with sleep apnea syndrome have episodes of blockage of their upper airways during sleep. The condition results in abnormal sleep and low blood oxygen during the night. Sleep apnea is common, occurring in 2% of women and 4% of men. Many people with the syndrome complain of daytime sleepiness, high blood pressure, trouble sleeping at night, or snoring, but they do not know that these symptoms are a result of sleep apnea syndrome. Primary care doctors often fail to detect sleep apnea in their patients. The only way to know for certain whether a person has sleep apnea is to monitor the person's sleep patterns, breathing, and heart function while they are sleeping (sleep studies). Sleep studies are expensive, uncomfortable, and inconvenient because they usually require the patient to spend the night in a special laboratory.

Why did the researchers do this particular study?

The researchers wanted to determine whether having patients complete a survey about sleep apnea would help primary care doctors identify patients who should have further testing for this condition.

Who was studied?

Adult patients in five primary care practices in Ohio.

How was the study done?

The researchers asked 744 patients to complete a survey that asked about snoring behavior, sleepiness, obesity, and high blood pressure. The survey was originally developed and tested in Berlin, Germany. They then classified patients as high risk or lower risk for sleep apnea based on their responses to the survey and performed sleep studies on 100 of the patients.

What did the researchers find?

The researchers classified 279 of the 744 patients as being at high risk for sleep apnea. 69 high-risk patients and 31 lower risk patients underwent sleep studies. Patients whose survey responses suggested that they were at high risk were almost 4 times more likely to have abnormal sleep studies than were those in the lower risk group.

What were the limitations of the study?

Only some of the patients underwent sleep studies. Also, these results may not be the same in other practices.

What are the implications of the study?

Use of this survey in primary care practices may help doctors to identify patients with sleep apnea syndrome. It might also prevent both missed diagnoses and unnecessary testing.





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