Sleep Apnea Clinical Score, Berlin Questionnaire, or Epworth Sleepiness Scale: which is the best obstructive sleep apnea predictor in patients with COPD?

Anamelia Costa Faria, Cláudia Henrique da Costa, Rogério Rufino Cardiopulmonology Department, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil Introduction: The Sleep Apnea Clinical Score (SACS) and the Berlin Questionnaire (BQ) are used to predict the likelihood...

Full description

Bibliographic Details
Main Authors: Faria AC, Costa CH, Rufino R
Format: Article
Language:English
Published: Dove Medical Press 2015-08-01
Series:International Journal of General Medicine
Online Access:http://www.dovepress.com/sleep-apnea-clinical-score-berlin-questionnaire-or-epworth-sleepiness--peer-reviewed-article-IJGM
_version_ 1811212424590655488
author Faria AC
Costa CH
Rufino R
author_facet Faria AC
Costa CH
Rufino R
author_sort Faria AC
collection DOAJ
description Anamelia Costa Faria, Cláudia Henrique da Costa, Rogério Rufino Cardiopulmonology Department, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil Introduction: The Sleep Apnea Clinical Score (SACS) and the Berlin Questionnaire (BQ) are used to predict the likelihood of obstructive sleep apnea (OSA). The Epworth Sleepiness Scale (ESS) is used to assess daytime sleepiness, a common OSA symptom. These clinical tools help prioritize individuals with the most severe illness regarding on whom polysomnography (PSG) should be performed. It is necessary to check the applicability of these tools in patients with chronic obstructive pulmonary disease (COPD). The aim of this study is to compare SACS, BQ, and ESS performance in patients with COPD. Methods: The SACS, BQ, and ESS were applied to 91 patients with COPD. From this group, 24 underwent PSG. In this transversal study, these three tests were compared regarding their likelihood to predict OSA in patients with COPD using receiver-operating characteristic curve statistics. Results: In this sample, 58 (63.7%) patients were men, and their mean age was 69.4±9.6 years. Fourteen patients (15.4%) had a high probability of OSA by SACS, 32 (32.5%) had a high probability by BQ, and 37 (40.7%) had excessive diurnal somnolence according to the ESS. From the 24 patients who underwent PSG, OSA diagnosis was confirmed in five (20.8%), according to the American Academy of Sleep Medicine criteria. BQ and ESS did not accurately predict OSA in this group of patients with COPD, with a receiver-operating characteristic curve area under the curves of 0.54 (95% CI: 0.329–0.745, P=0.75) and 0.69 (95% CI: 0.47–0.860, P=0.10), respectively. SACS performance was significantly better, with an area under the curve of 0.82 (95% CI: 0.606–0.943, P=0.02). Conclusion: SACS was better than BQ and ESS in predicting OSA in this group of patients with COPD. Keywords: overlap syndrome, COPD, emphysema, questionnaire, polysomnography, diagnosis
first_indexed 2024-04-12T05:29:11Z
format Article
id doaj.art-ad97254695474a63aeb8850b4054da72
institution Directory Open Access Journal
issn 1178-7074
language English
last_indexed 2024-04-12T05:29:11Z
publishDate 2015-08-01
publisher Dove Medical Press
record_format Article
series International Journal of General Medicine
spelling doaj.art-ad97254695474a63aeb8850b4054da722022-12-22T03:46:09ZengDove Medical PressInternational Journal of General Medicine1178-70742015-08-012015default27528123340Sleep Apnea Clinical Score, Berlin Questionnaire, or Epworth Sleepiness Scale: which is the best obstructive sleep apnea predictor in patients with COPD?Faria ACCosta CHRufino RAnamelia Costa Faria, Cláudia Henrique da Costa, Rogério Rufino Cardiopulmonology Department, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil Introduction: The Sleep Apnea Clinical Score (SACS) and the Berlin Questionnaire (BQ) are used to predict the likelihood of obstructive sleep apnea (OSA). The Epworth Sleepiness Scale (ESS) is used to assess daytime sleepiness, a common OSA symptom. These clinical tools help prioritize individuals with the most severe illness regarding on whom polysomnography (PSG) should be performed. It is necessary to check the applicability of these tools in patients with chronic obstructive pulmonary disease (COPD). The aim of this study is to compare SACS, BQ, and ESS performance in patients with COPD. Methods: The SACS, BQ, and ESS were applied to 91 patients with COPD. From this group, 24 underwent PSG. In this transversal study, these three tests were compared regarding their likelihood to predict OSA in patients with COPD using receiver-operating characteristic curve statistics. Results: In this sample, 58 (63.7%) patients were men, and their mean age was 69.4±9.6 years. Fourteen patients (15.4%) had a high probability of OSA by SACS, 32 (32.5%) had a high probability by BQ, and 37 (40.7%) had excessive diurnal somnolence according to the ESS. From the 24 patients who underwent PSG, OSA diagnosis was confirmed in five (20.8%), according to the American Academy of Sleep Medicine criteria. BQ and ESS did not accurately predict OSA in this group of patients with COPD, with a receiver-operating characteristic curve area under the curves of 0.54 (95% CI: 0.329–0.745, P=0.75) and 0.69 (95% CI: 0.47–0.860, P=0.10), respectively. SACS performance was significantly better, with an area under the curve of 0.82 (95% CI: 0.606–0.943, P=0.02). Conclusion: SACS was better than BQ and ESS in predicting OSA in this group of patients with COPD. Keywords: overlap syndrome, COPD, emphysema, questionnaire, polysomnography, diagnosishttp://www.dovepress.com/sleep-apnea-clinical-score-berlin-questionnaire-or-epworth-sleepiness--peer-reviewed-article-IJGM
spellingShingle Faria AC
Costa CH
Rufino R
Sleep Apnea Clinical Score, Berlin Questionnaire, or Epworth Sleepiness Scale: which is the best obstructive sleep apnea predictor in patients with COPD?
International Journal of General Medicine
title Sleep Apnea Clinical Score, Berlin Questionnaire, or Epworth Sleepiness Scale: which is the best obstructive sleep apnea predictor in patients with COPD?
title_full Sleep Apnea Clinical Score, Berlin Questionnaire, or Epworth Sleepiness Scale: which is the best obstructive sleep apnea predictor in patients with COPD?
title_fullStr Sleep Apnea Clinical Score, Berlin Questionnaire, or Epworth Sleepiness Scale: which is the best obstructive sleep apnea predictor in patients with COPD?
title_full_unstemmed Sleep Apnea Clinical Score, Berlin Questionnaire, or Epworth Sleepiness Scale: which is the best obstructive sleep apnea predictor in patients with COPD?
title_short Sleep Apnea Clinical Score, Berlin Questionnaire, or Epworth Sleepiness Scale: which is the best obstructive sleep apnea predictor in patients with COPD?
title_sort sleep apnea clinical score berlin questionnaire or epworth sleepiness scale which is the best obstructive sleep apnea predictor in patients with copd
url http://www.dovepress.com/sleep-apnea-clinical-score-berlin-questionnaire-or-epworth-sleepiness--peer-reviewed-article-IJGM
work_keys_str_mv AT fariaac sleepapneaclinicalscoreberlinquestionnaireorepworthsleepinessscalewhichisthebestobstructivesleepapneapredictorinpatientswithcopd
AT costach sleepapneaclinicalscoreberlinquestionnaireorepworthsleepinessscalewhichisthebestobstructivesleepapneapredictorinpatientswithcopd
AT rufinor sleepapneaclinicalscoreberlinquestionnaireorepworthsleepinessscalewhichisthebestobstructivesleepapneapredictorinpatientswithcopd