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In Turkey, all heavy‐vehicle driver's license applicants older than 45 years and with body mass index (BMI) >25 kg/m2 are required to have polysomnography (PSG). However, this law is usually overlooked in practice due to the large number of applications. We aimed to assess the usefulness of four standardized questionnaires: Berlin, STOP, STOP‐BANG and OSA50, in identifying the high‐risk bus drivers for obstructive sleep apnea (OSA). Ninety highway bus drivers underwent polysomnography and completed four questionnaires. They also underwent otolaryngologic evaluation and blood testing for probable co‐existing conditions such as diabetes and hypothyroidism. Neck circumference, BMI, waist circumference, prevalence of OSA and metabolic syndrome, oxygen desaturation index and duration of sleep associated with less than 90% saturation were significantly higher and mean oxygen saturation was significantly lower in drivers >45 years old than drivers <45 years old. STOP‐BANG questionnaire had the highest sensitivity (87%) and the highest negative predictive value (NPV) (76%) in identifying high‐risk for OSA. A cut off of 45 years old is suitable in screening highway bus drivers for OSA. Among the four questionnaires, STOP‐BANG questionnaire had the highest sensitivity and negative predictive value (NPV) in identifying high risk patients for OSA in highway bus drivers and can be safely used as a screening test in this group.

bRIEF SUmmARYCurrent knowledge/Study Rationale: Polysomnography is mandatory in drivers older than 45 years old and those with snoring, witnessed apnea and/or day time sleepiness who are younger than 45 years old, before getting a highway bus driver licence in Turkey, but the number of sleep centers are not enough to test all the applicants. This study has been done to test the accuracy of Watch-PAT device in detecting sleep disordered breathing among the highway bus drivers.

Obstructive sleep apnea syndrome (OSAS) provokes oxidative stress and ischemia, which affects the central nervous system. The degeneration of neurons in the brainstem due to periodic hypoxia can be evaluated by vestibular and audiologic tests. The objective of this study is to determine brainstem damage in severe OSAS patients with the help of vestibular evoked myogenic potential (VEMP) responses. Prospective, randomize, double-blind. Research-training hospital. We compared cervical vestibular evoked myogenic potential (cVEMP) responses between severe OSAS patients and a control group. 54 patients were included and divided into the OSAS group, with severe OSAS (apnea-hypopnea index, AHI >70), and a control group with snoring without OSAS (AHI <5). Both groups underwent cVEMP. Bilateral recordings with simultaneous binaural logon stimulations were used during VEMP recordings. The existing p1n1 and n2p2 responses, p1, n1, n2, and p2 latencies and amplitudes, and p1n1 and n2p2 intervals were measured. Statistically significant differences were revealed between patients and controls for the response rate of the p1n1, n2p2 and p1n1, n2p2 amplitudes. There were no significant differences between the two groups with respect to the latencies of p1, n1, n2 and p2, or the p1n1 and n2p2 intervals. The VEMP response rate was lower in severe OSAS patients, and all amplitudes were shorter than in healthy subjects. VEMP recordings in severe OSAS subjects demonstrates abnormalities in brainstem pathways. It appears that brainstem damage in severe OSAS can be detected by cVEMP recordings.

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