Prevalence of Symptoms and Risk of Sleep Apnea in Primary Care

Netzer, Nikolaus C.; Hoegel, Josef; Loube, Daniel I.; Netzer, Cordula M.; Hay, Birgit; Álvarez-Sala, R.; Strohl, Kingman P.

doi:10.1378/chest.124.4.1406

Cited by 242 publications

(223 citation statements)

References 24 publications

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“…Drager et al 42 found similar performance of the BQ in the hypertensive population. The high risk factor of coronary artery disease associated with OSA identified by the BQ was 34.4% in the control group and was similar to reports of the high risk factor of coronary artery disease associated with OSA identified by the BQ that ranged between 26 and 37.5% 17,26,43,44 . In contrast, the prevalence of OSA identified by the BQ in our control population was lower than the reported by Tufik et al 1 , using PSG, in a sample of the general population (49.3%).…”

Section: Controls Casessupporting

confidence: 84%

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

et al. 2012

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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.

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Section: Controls Casessupporting

confidence: 84%

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

et al. 2012

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“…Werden mindestens zwei Kategorien positiv bewertet, liegt ein hohes Risiko für eine obstruktive Schlafapnoe vor [16,17].…”

Section: Berlin−fragebogenunclassified

“…Standardisierte Fragebögen können zur effizienteren Erhebung der Anamnese und somit zu Kostensenkungen beitragen. So zeigt der Berlin−Fragebogen eine hohe Sensitivität und eine an− nehmbare Spezifität in einem Kollektiv, das sich aus Patienten zusammensetzt, die in Allgemeinkrankenhäusern und allge− meinmedizinischen Praxen behandelt wurden [16,17] …”

unclassified

Ist der Berlin-Fragebogen ein geeignetes Instrument der schlafmedizinischen Diagnostik in der pneumologischen Rehabilitation?

Weinreich

Plein²,

Teschler³

et al. 2006

Pneumologie

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The Berlin Questionnaire is an ex− plorative tool of 13 questions designed to identify patients with obstructive sleep apnea. The ques− tions are targeted toward key symptoms of snor− ing, apneas, daytime sleepiness, hypertension and overweight. Methods: 153 patients undergoing pulmonary rehabilitation were screened for obstructive sleep apnea via i) ApneaLink (ResMed, Munich) and ii) the Berlin Questionnaire. The Epworth Sleepiness Scale (ESS) was administered to grade daytime sleepiness. Results of ApneaLink screening and questionnaires were prospectively compared. The Respiratory Disturbance Index (RDI) was used to compute predictive perfor− mance of the Berlin Questionnaire for obstructive sleep apnea. Results were also compared to pre− viously published data from a primary care pa− tient cohort. Results: At a cut−off RDI = 10/h, the Berlin Ques− tionnaire had a sensitivity of 62.5 %, a specificity of 53.8 %, a positive predictive value of 38.4 %, a negative predictive value of 74.2 %, a positive like− lihood ratio of 1.35 and a negative likelihood ratio of 0.69. At a cut−off RDI = 15/h, the Berlin Ques− tionnaire had a sensitivity of 67.2 %, a specificity of 52.8 %, a positive predictive value of 25.1 %, a negative predictive value of 84.7 %, a positive likelihood ratio of 1.42 and a negative likelihood ratio of 0.62. There was evidence that the partici− pants of this study suffered from an increased daytime sleepiness (ESS = 8.8 4.8). The study group was more likely to snore, have apneas (men 6.7 % more often, women 12.6 % more often) and suffer from daytime sleepiness (men 19.0 % more often, women 14.6 % more often) than the control group. Also, hypertension and overweight were more prevalent (men 6.1 % more often, women 11.1 % more often).

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“…Knowledge from primary care studies can facilitate nurses to identify patients with a high cost-benefit for referral to sleep clinics. Questionnaires, such as the BSAQ [9,30] and simple two channel recording devices [31] may be suitable for nurses working at hypertensive clinics in primary care to identify patients. However, they are not comparable to validated diagnostic tools, such as polygraphy or polysomnography, and need to be more thoroughly evaluated regarding sensitivity and specificity.…”

Section: Discussionmentioning

confidence: 99%

Undiagnosed obstructive sleep apnea in hypertensive outpatients in primary care—Associations with sleep complaints, depressive symptoms and global perceived health

Broström¹,

Sunnergren²,

Årestedt³

et al. 2013

OJN

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Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjective sleep complaints, depressive symptoms and global perceived health. Design: Cross-sectional design focusing on nursing care outcomes of obstructtive sleep apnea. Setting: Four primary care health centres in Sweden. PATIENTS: 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed hypertension (BP > 140/90). Main Outcome Measures: Prevalence of OSA and depressive symptoms, and association of OSA to sleep complaints, depressive symptoms and global perceived health. RESULTS: Mild, moderate and severe OSA was seen among 29%, 16% and 14% of patients, respectively. Depressive symptoms were seen in 16% of the total group, with a higher prevalence among men, compared to women, 21% vs. 12%. No differences were found regarding blood pressure, estimated sleep need, sleep sufficiency index, insomnia symptoms, daytime sleepiness or depressive symptoms with respect to different degrees of OSA. Apnea-hypopnea index was significantly associated to perceived health after adjustment for gender and comorbidities, but when depressive symptoms and non-restorative sleep were added to the model, 33% of the variance in global perceived health was explained. Conclusion: OSA is highly prevalent among patients with hypertension in primary care and does together with sleep complaints and depressive symptoms have a negative impact on global perceived health. Hypertensive patients without subjective sleep complaints or depressive symptoms may still have OSA.

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Prevalence of Symptoms and Risk of Sleep Apnea in Primary Care

Cited by 242 publications

References 24 publications

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

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

Ist der Berlin-Fragebogen ein geeignetes Instrument der schlafmedizinischen Diagnostik in der pneumologischen Rehabilitation?

Undiagnosed obstructive sleep apnea in hypertensive outpatients in primary care—Associations with sleep complaints, depressive symptoms and global perceived health

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