Indian Journal of Sleep Medicine

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VOLUME 1 , ISSUE 1 ( January-March, 2006 ) > List of Articles

ORIGINAL ARTICLE

Questionnaire for diagnosing Obstructive Sleep Apnoea in Indians

Mittal A, Vijayan VK, Patial K

Keywords : polysomnography., reliability, validity,sleep related breathing disorders

Citation Information : A M, VK V, K P. Questionnaire for diagnosing Obstructive Sleep Apnoea in Indians. Indian Sleep Med 2006; 1 (1):50-57.

DOI: 10.5005/ijsm-1-1-50

License: CC BY-SA 4.0

Published Online: 00-00-0000

Copyright Statement:  Copyright © 2006; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective To construct a questionnaire for estimation of sleep related breathing disorders in Indians. Methodology To assess the inter-observer reliability, a specialist and a trained health worker administered the questionnaire to 135 adult individuals, who presented in the outpatient department of V.P. Chest Institute. Taking the specialist\'s opinion as the reference, various parameters of reliability were calculated. The test-retest reliability was calculated by questioning 50 individuals twice after an interval of one week by the same observer. The questionnaire was validated by performing polysomnography on 11 normal and 11 individuals with sleep related symptoms suggestive of obstructive sleep apnoea (based on the questionnaire). Results The sensitivity, specificity and predictive values were calculated for each question. While sensitivity ranged from 42 - 55% (questions on snoring and daytime sleepiness with a sensitivity of 87% and 93% respectively), specificity was found to be 94 – 96% with an efficiency of 0.899. The kappa value for intra-observer reliability was found to be 0.815. With polysomnography as the gold standard for diagnosing sleeprelated breathing disorders, the questionnaire had a sensitivity of and specificity of 82%. Discussion Our questionnaire compares favourably with other standard questionnaires like the Berlin Questionnaire. Conclusion This short questionnaire with good reliability is suitable for Indian population studies.


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  1. Guilleminault C. Clinical features and evaluation of obstructive sleep apnea, In : Kryger MH, Roth T, Dement WC, eds. Principles & practice of sleep medicine. Philadelphia : WB Saunders, 1989: 552-558.
  2. Ferguson KA, Fleetham JA. Sleep related breathing disorders: 4. Consequences of sleep disordered breathing. Thorax 1995; 50: 998-1004.
  3. Hla KM, Young TB, Bidwell T et al. Sleep apnea and hypertension : a population based study. Ann Intern Med 1994; 120: 382-388.
  4. Feran-Santos J, Jimenez-Gomez A, Cordero-Guevara J and the Co-operative Group Burgos-Santanda. The association between sleep apnea and the risk of traffic accidents. N Engl J Med 1999;340: 847-851.
  5. He J, Kryger MH, Zorick F J Conway W, Roth T. Mortality and apnea index in obstructive sleep apnea. Chest 1988; 94: 9-14.
  6. Partinen M, Jamieson A, Guilleminault CG. Long term outcome for obstructive sleep apnea syndrome patients : mortality. Chest 1988; 94: 1200-1204.
  7. Findley L, M Unverzedt and P Suratt. Automobile accidents in patients with obstructive sleep apnea. Am Rev Respir Dis 1988; 137: 337-340.
  8. Kales A, Caldwell A, Cadeaux R, Vela- Bueno A, Ruch L, Mayes S. Severe obstructive sleep apnea : II. associated psychopathology and psychosocial consequences. J Chronic Disease 1985; 38: 427-434.
  9. Parish J, Shepard JW. Cardiovascular effects of sleep disorders. Chest 1990; 97: 1220-1226.
  10. Hung J, Whitford EG, Parsons RW, Hillman DR. Association of sleep apnea with myocardial infarction in men. Lancet 1990; 336: 261-264.
  11. Redline S, Strauss ME, Adam N, Winters M, Roebuck T, Sprig K, Rosenburg C, Adams K. Neuropsychological function in mild sleep disordered breathing. Sleep 1997; 20: 160-167.
  12. Bliwise DL, Bliwise NG, Partinen M, Pursley AM, Dement WC. Sleep apnea and mortality in an aged cohort. Am J Public Health 1988; 78: 544-547.
  13. Lavie P, Herer P, Peled R, Berger I, Yoffe N, Zomer J, Rubin AE. Mortality in sleep apnea patients: a multivariate analysis of risk factors. Sleep 1995; 18: 149-157.
  14. Barbe F, Pericas J, Munoz A, Findley L, Avto JM, Aguste AGN. Automobile accidents in patients with sleep apnea syndrome: an epidemiological and mechanistic study. Am J Respir Crit Care Med 1998; 158: 18-22.
  15. Young T, Blustein J, Finn L, PaltaM. Sleep-disordered breathing and motor vehicle accidents in a populationbased sample of employed adults. Sleep 1997; 20: 681- 683.
  16. Thorpy MJ. ed. The international classification of sleep disorders. Rochester:American Sleep Disorders Association 1990.
  17. Douglas NJ. The sleep apnea /hypopnea syndrome and snoring. BMJ 1993; 306 :1057-60.
  18. Deegan PC, Mc Nicholas WT. Predictive values of clinical features for the obstructive sleep apnoea syndrome. Eur Respir J 1996; 9: 117-124.
  19. Crocker BD, Olson LG, Saunders NA, Hensley MJ, MC Keon JL, Allen KM. Estimation of the probability of disturbed breathing during sleep before a sleep study. Am Rev Respir Dis 1990; 142: 14-18.
  20. Netzer NC, Riccardo A, Strohs Ra, Netzer Cm, Clarck K and Stroh Kp. Using the Berlin Questionnaire to identify patients at risk for the Sleep Apnea Syndrome. Ann Intern Med 1999; 131(70: 485-491.
  21. Ward B, Chung F, Yuan H, Kayumov L, Shapiro C. The Sleep Apnea Preoperative Screen (SLAPS) – A new screening tool for sleep apnea. Anaesthesiology 2004; 101: A14.
  22. Partinen M, Gislason T. Basic Nordic Sleep Questionnaire BSNQ: a quantitated measure of subjective sleep complaints. J Sleep Res 1995; 4(1): 150-155.
  23. Coggon D, Rose G, Barker DJP. Epidemiology for the uninitiated, 3rd ed. London: BMJ Publishing Group 1993; 99.
  24. Grimes DA, Schulz KE. An overview of clinical research: the lay of the land. Lancet 2002; 359: 57-61.
  25. Janson C, Gislason T, De Backer W et al. Prevalence of sleep disturbances among young adults in three European countries. Sleep 1995; 18: 589-597.
  26. Thomson WD, Walter SD. A reappraisal of the kappa coefficient. J Clin Epidem 1998; 41: 949-958.
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