Usefulness of the Berlin Questionnaire to identify patients at high risk for obstructive sleep apnea: a population-based door-to-door study

Abstract

The Berlin Questionnaire (BQ) is a useful tool to identify the high-risk group for obstructive sleep apnea (OSA) in the primary care sites or hospital, but the usefulness of the BQ to identify the high-risk group for OSA in the general population has not been evaluated. The purpose of our study was to develop the Korean version of the BQ (KBQ) and evaluate the usefulness of the BQ in identifying patients with OSA in the general population. A total of 1,305 subjects were included in a population-based door-to-door cross-sectional study. For validation of the KBQ, an overnight polysomnography (PSG) was performed on 101 subjects who were randomly selected considering their age, sex, and risk group classification at a controlled sleep laboratory. The KBQ showed a relatively good to excellent internal consistency (Cronbach's alpha correlation 0.64-0.78) and test-retest reliability (intraclass correlation 0.92). The apnea-hypopnea index (AHI) was significantly correlated with the scores in each category and the total scores of the KBQ. In addition, high risk grouping based on the KBQ predicted an AHI a parts per thousand yenaEuro parts per thousand 5 with a sensitivity of 0.69 and a specificity of 0.83. According to the risk categorization based on the KBQ, 26.1 % subjects were in the high-risk group for OSA which was similar to the prevalence of OSA in a previous large epidemiological study using PSG in Korea. This is the first study to confirm the usefulness of the BQ as a screening tool for OSA by prioritizing subjects at high risk for OSA in the general population.