Vergleich zwischen Epworth und Berliner Fragebogen zur Vorhersagewahrscheinlichkeit für Polysomnographieergebnisse bei Patienten mit Verdacht auf schlafbezogene Atmungsstörungen

Abstract

Background: Epworth Sleepiness Scale (EES) and Berlin Questionnaire (BQ) are widely used, short, self administered questionnaires for the screening of patients with sleep disordered breathing (SDB). Whereas the ESS is asking for symptoms of daytime sleepiness and fatigue only, the BQ asks for symptoms of snoring and apneas, daytime sleepiness and the risk factors of extreme obesity and high arterial blood pressure. Objective: We wanted to investigate the sensitivity and specificity of both questionnaires for the pretest probability of sleep disordered breathing in a group of patients with highly suspected SDB. Methods: 1085 consecutives patients of our sleeplaboratory were asked to answer the ESS and BQ parallel before testing (polysomnography/PSG). The questionnaire scores were compared with PSG-results. Results: 1. BQ showed positiv risk in 870/994 SDB patients (sensitivity 87.53 %) and negative risk in 52/86 non SDB patients (specificity 60.47 %); ESS in 605/983 (sensitivity 61.55 %) and in 42/84 (specificity 50.00 %). 2. False negative results were generated by the BQ in 124 out of 994 SDB cases (12.5 %) and by the ESS in 378 out of 983 (38.5 %). 3. Obesity was not a specific marker for SDB. Depending on stature and weight a Body Mass Index over 30 kg/m2 was defined as obesity. Only 51,5 % of all 999 SDB patients were obese. 4. As one more result, high blood pressure has not pointed at SDB. In our study 52.2 % of all SDB patients had no high blood pressure. Conclusions: In comparison between the BQ and the ESS, the BQ has shown a much higher sensitivity (87.53 %) and a higher specificity (60.47 %) than the ESS (sensitivity: 61.53 %, specificity: 50.00 %) regarding the pretest probability of this selected patient group. Neither the BMI nor high blood pressure seemed to be relevant in the diagnosis of SDB in our selected patient group. Based on these results the combination of irregular snoring and daytime sleepiness questioned by the BQ pre-defines SDB best.