Accuracy of sleep questionnaires for obstructive sleep apnea syndrome screening

Background: Simple but accurate tools should be used to identify patients with obstructive sleep apnea syndrome (OSAS), aiming at an early detection and prevention of serious consequences. Aim: To assess the predictive value of four sleep questionnaires (Berlin, Epworth Sleepiness Scale [ESS], STOP, and STOP-Bang) in the screening of patients with OSAS. Material and Methods: The four sleep questionnaires were administered to 1,050 snorers aged 56 +/- 15 years (68% males) assessed at a sleep clinic. An overnight unattended respiratory polygraphy was performed to all patients to confirm the diagnosis of OSAS. The sensitivity, specificity, positive and negative predictive values of the four questionnaires were calculated. Results: Eighty four percent of participants had OSAS. The clinical variables associated with OSAS risk were age, male gender, hypertension, overweight, cervical circumference, waist/hip ratio, history of snoring, witnessed apneas and nycturia. Eighty-three, 86, 92 and 46 % of cases were classified as having a high risk for OSAS, according to the Berlin, STOP and STOP-Bang questionnaires and ESS, respectively. STOP and STOP-Bang questionnaires had the highest sensitivity to predict OSAS (88 and 95%, respectively) while the Flemons Index had the highest specificity (82%). Conclusions: Sleep questionnaires were able to identify patients with a high risk for OSAS but without accurately excluding those at low risk.