Obstructive sleep apnea, detected by the Berlin Questionnaire: an associated risk factor for coronary artery disease

Abstract

Obstructive sleep apnea (OSA), a risk factor for coronary artery disease, remains under diagnosed. We investigated if OSA identified by the Berlin Questionnaire (BQ) is associated with the risk of coronary artery disease. Cases were patients referred for elective coronariography. The cases were classified with significant coronary lesions (stenosis > 50% in an epicardial coronary) or without significant coronary lesions. Controls were selected from a population-based sample. Positive BQ results were identified in 135 (41.2%) of 328 cases, in contrast with 151 (34.4%) of 439 control subjects (p = 0.03). In a multinomial logistic analysis, the risk for OSA identified by the BQ was independently associated with coronary artery disease in cases with lesions of at least 50% (OR = 1.53; 95%CI: 1.02-2.30; p = 0.04). The risk from OSA identified by the BQ was higher in younger subjects (40-59 years) (OR = 1.76; 95%CI: 1.05-2.97; p = 0.03) and in women (OR = 3.56; 95%CI: 1.64-7.72; p = 0.001). In conclusion, OSA identified by the BQ greatly increases the risks of coronary artery disease in patients having significant coronary artery lesions indicated by anangiogram, particularly in younger individuals and in women.

Risk factors for, and prevalence of, sleep apnoea in cardiac rehabilitation facilities in Germany: The Reha-Sleep registry

“…46 The Berlin Questionnaire has also been used in other studies to show independent associations between OSA, hypertension and CAD. 47,48 This is in accordance with the findings of the current study, in which more patients had hypertension, CABG, valve replacement or type 2 diabetes, corresponding to data showing a link between severity of SDB and extent of coronary atherosclerosis. 49 However, caution needs to be exercised when using the Berlin Questionnaire because a high prevalence of obesity and hypertension has been shown to limit the ability of this tool to discriminate between post-myocardial infarction patients with or without SDB.…”

Impact of High Risk for Obstructive Sleep Apnea on Survival after Acute Coronary Syndrome: Insights from the ERICO Registry

“…Most of the studies that evaluate OSA as a prognostic factor for cardiovascular events studied specific subsamples of acute and chronic coronary syndrome, 5,9 STEMI, 8 unstable angina or CABG, 6,7,23 and used polysomnography to measure OSA with positive results. However, other studies using simple questions 24 or specific questionnaires to measure OSA 12,14 have also found positive associations. 25 Although some studies in Brazil used the Berlin questionnaire to evaluate the relationship between OSA and other endpoints, 11-13 only two evaluated the association of OSA defined by the Berlin questionnaire with cardiovascular events.…”

Sleep disorders in polycystic ovary syndrome: influence of obesity and hyperandrogenism

“…22,23 The Berlin questionnaire, previously validated in a Brazilian Portuguese version, was used to assess the risk for sleep apnea. 24,25 Using this questionnaire's total score, it is possible to differentiate "good sleepers" (score≤5) and "poor sleepers" (score>5). Also, daytime somnolence was evaluated subjectively using the Epworth sleepiness scale (ESS), 26 with a score ≥10 considered excessive daytime sleepiness.…”