Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2013

Open Access 01-12-2013 | Research article

Translation and validation of Berlin questionnaire in primary health care in Greece

Authors: Izolde Bouloukaki, Ioannis D Komninos, Charalampos Mermigkis, Katerina Micheli, Maria Komninou, Violeta Moniaki, Eleni Mauroudi, Nikolaos M Siafakas, Sophia E Schiza

Published in: BMC Pulmonary Medicine | Issue 1/2013

Login to get access

Abstract

Background

The aim of our study was to validate a Greek translation of the Berlin Questionnaire (BQ) for obstructive sleep apnoea syndrome (OSAS) and to explore whether this screening questionnaire could be used to help identify primary care patients at greater risk of having OSAS.

Methods

We recruited 189 patients visiting a primary health care setting on the island of Crete, Greece. They all completed the Greek Version of the BQ. Patients were then referred to a Sleep Disorders Unit for evaluation of suspected sleep-disordered breathing.

Results

A PSG study was performed in 129 of the 189 subjects (68.3%). BQ identified 74.4% (n = 96) of the patients as high-risk for OSAS and the remaining 25.6% (n = 33) as low-risk. The sensitivity and specificity of BQ for OSAS diagnosis were 76% and 40%, respectively, for an apnoea–hypopnoea index (AHI) ≥5 per hour but <15 per hour, 84% and 61% for an AHI ≥15 per hour but ≤30 per hour, and 79% and 39% for an AHI >30 per hour.

Conclusions

In conclusion, the Greek Version of the BQ is a useful instrument for identifying patients at risk for OSAS in primary health care in Greece. The findings of our study confirm that such screening tools should be used by primary care clinicians for OSAS prediction.
Appendix
Available only for authorised users
Literature
1.
go back to reference Bahammam A, Delaive K, Ronald J, Manfreda J, Roos L, Kryger MH: Health care utilization in males with obstructive sleep apnea syndrome two years after diagnosis and treatment. Sleep. 1999, 22: 740-747.PubMed Bahammam A, Delaive K, Ronald J, Manfreda J, Roos L, Kryger MH: Health care utilization in males with obstructive sleep apnea syndrome two years after diagnosis and treatment. Sleep. 1999, 22: 740-747.PubMed
2.
go back to reference Bixler EO, Vgontzas AN, Lin HM, et al: Association of hypertension and sleep-disordered breathing. Arch Intern Med. 2000, 160: 2289-2295. 10.1001/archinte.160.15.2289.CrossRefPubMed Bixler EO, Vgontzas AN, Lin HM, et al: Association of hypertension and sleep-disordered breathing. Arch Intern Med. 2000, 160: 2289-2295. 10.1001/archinte.160.15.2289.CrossRefPubMed
3.
go back to reference Dyken ME, Somers VK, Yamada T, Ren ZY, Zimmerman MB: Investigating the relationship between stroke and obstructive sleep apnea. Stroke. 1996, 27: 401-407. 10.1161/01.STR.27.3.401.CrossRefPubMed Dyken ME, Somers VK, Yamada T, Ren ZY, Zimmerman MB: Investigating the relationship between stroke and obstructive sleep apnea. Stroke. 1996, 27: 401-407. 10.1161/01.STR.27.3.401.CrossRefPubMed
4.
go back to reference He J, Kryger MH, Zorick FJ, Conway W, Roth T: Mortality and apnea index in obstructive sleep apnea. Experience in 385 male patients. Chest. 1988, 94: 9-14. 10.1378/chest.94.1.9.CrossRefPubMed He J, Kryger MH, Zorick FJ, Conway W, Roth T: Mortality and apnea index in obstructive sleep apnea. Experience in 385 male patients. Chest. 1988, 94: 9-14. 10.1378/chest.94.1.9.CrossRefPubMed
5.
go back to reference Hung J, Whitford EG, Parsons RW, Hillman DR: Association of sleep–apnea with myocardial-infarction in Men. Lancet. 1990, 336: 261-264. 10.1016/0140-6736(90)91799-G.CrossRefPubMed Hung J, Whitford EG, Parsons RW, Hillman DR: Association of sleep–apnea with myocardial-infarction in Men. Lancet. 1990, 336: 261-264. 10.1016/0140-6736(90)91799-G.CrossRefPubMed
6.
go back to reference Young T, Peppard PE, Gottlieb DJ: Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002, 165: 1217-1239. 10.1164/rccm.2109080.CrossRefPubMed Young T, Peppard PE, Gottlieb DJ: Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002, 165: 1217-1239. 10.1164/rccm.2109080.CrossRefPubMed
7.
go back to reference Young T, Evans L, Finn L, Palta M: Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 1997, 20: 705-706.PubMed Young T, Evans L, Finn L, Palta M: Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 1997, 20: 705-706.PubMed
8.
go back to reference Kushida CA, Littner MR, Morgenthaler T, et al: Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep. 2005, 28: 499-521.PubMed Kushida CA, Littner MR, Morgenthaler T, et al: Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep. 2005, 28: 499-521.PubMed
9.
go back to reference Ramachandran SK, Josephs LA: A meta-analysis of clinical screening tests for obstructive sleep apnea. Anesthesiology. 2009, 110: 928-939. 10.1097/ALN.0b013e31819c47b6.CrossRefPubMed Ramachandran SK, Josephs LA: A meta-analysis of clinical screening tests for obstructive sleep apnea. Anesthesiology. 2009, 110: 928-939. 10.1097/ALN.0b013e31819c47b6.CrossRefPubMed
10.
go back to reference Flemons WW, Douglas NJ, Kuna ST, Rodenstein DO, Wheatley J: Access to diagnosis and treatment of patients with suspected sleep apnea. Am J Respir Crit Care Med. 2004, 169: 668-672. 10.1164/rccm.200308-1124PP.CrossRefPubMed Flemons WW, Douglas NJ, Kuna ST, Rodenstein DO, Wheatley J: Access to diagnosis and treatment of patients with suspected sleep apnea. Am J Respir Crit Care Med. 2004, 169: 668-672. 10.1164/rccm.200308-1124PP.CrossRefPubMed
11.
go back to reference Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP: Using the Berlin questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999, 131: 485-491.CrossRefPubMed Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP: Using the Berlin questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999, 131: 485-491.CrossRefPubMed
12.
go back to reference Prieto AJ: A method for translation of instruments to other languages. Adult Education Quaterly. 1992, 43: 1-14. 10.1177/0741713692043001001.CrossRef Prieto AJ: A method for translation of instruments to other languages. Adult Education Quaterly. 1992, 43: 1-14. 10.1177/0741713692043001001.CrossRef
13.
go back to reference Johns MW: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991, 14: 540-545.PubMed Johns MW: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991, 14: 540-545.PubMed
14.
go back to reference Iber K, Ancoli-Israel S, Chesson AL, Quan SF: The AASM manual for the scoring of sleep and associated events. 2007, Westchester, IL: American Academy of Sleep Medicine Iber K, Ancoli-Israel S, Chesson AL, Quan SF: The AASM manual for the scoring of sleep and associated events. 2007, Westchester, IL: American Academy of Sleep Medicine
15.
go back to reference Strauss R, Browner W: Letter to the editor: sensitivity, specificity and positive predictive value of Berlin questionnaire. Ann Intern Med. 2000, 132: 758-759.CrossRefPubMed Strauss R, Browner W: Letter to the editor: sensitivity, specificity and positive predictive value of Berlin questionnaire. Ann Intern Med. 2000, 132: 758-759.CrossRefPubMed
16.
go back to reference Ahmadi N, Chung SA, Gibbs A, Shapiro CM: The Berlin questionnaire for sleep apnea in a sleep clinic population: relationship to polysomnographic measurement of respiratory disturbance. Sleep Breath. 2008, 12: 39-45. 10.1007/s11325-007-0125-y.CrossRefPubMed Ahmadi N, Chung SA, Gibbs A, Shapiro CM: The Berlin questionnaire for sleep apnea in a sleep clinic population: relationship to polysomnographic measurement of respiratory disturbance. Sleep Breath. 2008, 12: 39-45. 10.1007/s11325-007-0125-y.CrossRefPubMed
17.
go back to reference Khassawneh B, Ghazzawi M, Khader Y, et al: Symptoms and risk of obstructive sleep apnea in primary care patients in Jordan. Sleep Breath. 2009, 13: 227-232. 10.1007/s11325-008-0240-4.CrossRefPubMed Khassawneh B, Ghazzawi M, Khader Y, et al: Symptoms and risk of obstructive sleep apnea in primary care patients in Jordan. Sleep Breath. 2009, 13: 227-232. 10.1007/s11325-008-0240-4.CrossRefPubMed
18.
go back to reference Adewole OO, Hakeem A, Fola A, Anteyi E, Ajuwon Z, Erhabor G: Obstructive sleep apnea among adults in Nigeria. J Natl Med Assoc. 2009, 101: 720-725.CrossRefPubMed Adewole OO, Hakeem A, Fola A, Anteyi E, Ajuwon Z, Erhabor G: Obstructive sleep apnea among adults in Nigeria. J Natl Med Assoc. 2009, 101: 720-725.CrossRefPubMed
19.
go back to reference Chung F, Yegneswaran B, Liao P, et al: Validation of the Berlin questionnaire and American society of anesthesiologists checklist as screening tools for obstructive sleep apnea in surgical patients. Anesthesiology. 2008, 108: 822-830. 10.1097/ALN.0b013e31816d91b5.CrossRefPubMed Chung F, Yegneswaran B, Liao P, et al: Validation of the Berlin questionnaire and American society of anesthesiologists checklist as screening tools for obstructive sleep apnea in surgical patients. Anesthesiology. 2008, 108: 822-830. 10.1097/ALN.0b013e31816d91b5.CrossRefPubMed
20.
go back to reference Khiani VS, Salah W, Maimone S, Cummings L, Chak A: Sedation during endoscopy for patients at risk of obstructive sleep apnea. Gastrointest Endosc. 2009, 70: 1116-1120. 10.1016/j.gie.2009.05.036.CrossRefPubMed Khiani VS, Salah W, Maimone S, Cummings L, Chak A: Sedation during endoscopy for patients at risk of obstructive sleep apnea. Gastrointest Endosc. 2009, 70: 1116-1120. 10.1016/j.gie.2009.05.036.CrossRefPubMed
21.
go back to reference Brown DL, Zahuranec DB, Majersik JJ, et al: Risk of sleep apnea in orchestra members. Sleep Med. 2009, 10: 657-660. 10.1016/j.sleep.2008.05.013.CrossRefPubMed Brown DL, Zahuranec DB, Majersik JJ, et al: Risk of sleep apnea in orchestra members. Sleep Med. 2009, 10: 657-660. 10.1016/j.sleep.2008.05.013.CrossRefPubMed
22.
go back to reference Chilukuri K, Dalal D, Marine JE, et al: Predictive value of obstructive sleep apnoea assessed by the Berlin questionnaire for outcomes after the catheter ablation of atrial fibrillation. Europace. 2009, 11: 896-901. 10.1093/europace/eup064.CrossRefPubMed Chilukuri K, Dalal D, Marine JE, et al: Predictive value of obstructive sleep apnoea assessed by the Berlin questionnaire for outcomes after the catheter ablation of atrial fibrillation. Europace. 2009, 11: 896-901. 10.1093/europace/eup064.CrossRefPubMed
23.
go back to reference Vaz AP, Drummond M, Mota PC, Severo M, Almeida J, Winck JC: Translation of Berlin questionnaire to Portuguese language and its application in OSA identification in a sleep disordered breathing clinic. Rev Port Pneumol. 2011, 17: 59-65. 10.1016/S0873-2159(11)70015-0.CrossRefPubMed Vaz AP, Drummond M, Mota PC, Severo M, Almeida J, Winck JC: Translation of Berlin questionnaire to Portuguese language and its application in OSA identification in a sleep disordered breathing clinic. Rev Port Pneumol. 2011, 17: 59-65. 10.1016/S0873-2159(11)70015-0.CrossRefPubMed
24.
go back to reference Gus M, Gonçalves SC, Martinez D, et al: Risk for obstructive sleep apnea by Berlin questionnaire, but not daytime sleepiness, is associated with resistant hypertension: a case–control study. Am J Hypertens. 2008, 21: 832-835. 10.1038/ajh.2008.184.CrossRefPubMed Gus M, Gonçalves SC, Martinez D, et al: Risk for obstructive sleep apnea by Berlin questionnaire, but not daytime sleepiness, is associated with resistant hypertension: a case–control study. Am J Hypertens. 2008, 21: 832-835. 10.1038/ajh.2008.184.CrossRefPubMed
25.
go back to reference Sharma SK, Vasudev C, Sinha S, Banga A, Pandey RM, Handa KK: Validation of the modified Berlin questionnaire to identify patients at risk for the obstructive sleep apnoea syndrome. Indian J Med Res. 2006, 124: 281-290.PubMed Sharma SK, Vasudev C, Sinha S, Banga A, Pandey RM, Handa KK: Validation of the modified Berlin questionnaire to identify patients at risk for the obstructive sleep apnoea syndrome. Indian J Med Res. 2006, 124: 281-290.PubMed
26.
go back to reference Saleh AB, Ahmad MA, Awadalla NJ: Development of Arabic version of Berlin questionnaire to identify obstructive sleep apnea at risk patients. Ann Thorac Med. 2011, 6: 212-216. 10.4103/1817-1737.84775.CrossRefPubMedPubMedCentral Saleh AB, Ahmad MA, Awadalla NJ: Development of Arabic version of Berlin questionnaire to identify obstructive sleep apnea at risk patients. Ann Thorac Med. 2011, 6: 212-216. 10.4103/1817-1737.84775.CrossRefPubMedPubMedCentral
27.
go back to reference Weinreich G, Plein K, Teschler T, Resler J: Is the Berlin questionnaire an appropriate diagnostic tool for sleep medicine in pneumological rehabilitation. Pneumologie. 2006, 60: 737-742. 10.1055/s-2006-944270.CrossRefPubMed Weinreich G, Plein K, Teschler T, Resler J: Is the Berlin questionnaire an appropriate diagnostic tool for sleep medicine in pneumological rehabilitation. Pneumologie. 2006, 60: 737-742. 10.1055/s-2006-944270.CrossRefPubMed
28.
go back to reference Ford DE, Kamerow DB: Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention?. JAMA. 1989, 262: 1479-1484. 10.1001/jama.1989.03430110069030.CrossRefPubMed Ford DE, Kamerow DB: Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention?. JAMA. 1989, 262: 1479-1484. 10.1001/jama.1989.03430110069030.CrossRefPubMed
29.
go back to reference Lu CL, Lee YC, Tsai SJ, Hu PG, Sim CB: Psychiatric disturbances associated with hyperthyroidism: an analysis report of 30 cases. Zhonghua Yi Xue Za Zhi (Taipei). 1995, 56: 393-398. Lu CL, Lee YC, Tsai SJ, Hu PG, Sim CB: Psychiatric disturbances associated with hyperthyroidism: an analysis report of 30 cases. Zhonghua Yi Xue Za Zhi (Taipei). 1995, 56: 393-398.
30.
go back to reference Guilleminault C, Czeisler C, Coleman R, Miles L: Circadianrhythm disturbances and sleep disorders in shift workers. Electroencephalogr Clin Neurophysiol Suppl. 1982, 36: 709-714.PubMed Guilleminault C, Czeisler C, Coleman R, Miles L: Circadianrhythm disturbances and sleep disorders in shift workers. Electroencephalogr Clin Neurophysiol Suppl. 1982, 36: 709-714.PubMed
31.
go back to reference Melamed S, Oksenberg A: Excessive daytime sleepiness and risk of occupational injuries in non-shift daytime workers. Sleep. 2002, 25: 315-322.PubMed Melamed S, Oksenberg A: Excessive daytime sleepiness and risk of occupational injuries in non-shift daytime workers. Sleep. 2002, 25: 315-322.PubMed
33.
Metadata
Title
Translation and validation of Berlin questionnaire in primary health care in Greece
Authors
Izolde Bouloukaki
Ioannis D Komninos
Charalampos Mermigkis
Katerina Micheli
Maria Komninou
Violeta Moniaki
Eleni Mauroudi
Nikolaos M Siafakas
Sophia E Schiza
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2013
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/1471-2466-13-6

Other articles of this Issue 1/2013

BMC Pulmonary Medicine 1/2013 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.