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Protocol - Sleep Apnea - Adult

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Description:

The questionnaire asks about risk factors for sleep apnea, namely snoring behavior, wake time, sleepiness or fatigue, and the presence of high blood pressure. The protocol begins with information that an individual self-reports on height, weight, age, and sex. The 10 questions address snoring, fatigue, and high blood pressure. An algorithm is provided to classify study participants into high or low risk on the basis of their response.

Protocol:

Height (m) ________ Weight (kg)________ Age______ Male / Female

Please choose the correct response to each question.

CATEGORY 1

1. Do you snore?

[ ] a. Yes

[ ] b. No

[ ] c. Don’t know

If you snore:

2. Your snoring is:

[ ] a. Slightly louder than breathing

[ ] b. As loud as talking

[ ] c. Louder than talking

[ ] d. Very loud can be heard in adjacent rooms

3. How often do you snore?

[ ] a. Nearly every day

[ ] b. 3-4 times a week

[ ] c. 1-2 times a week

[ ] d. 1-2 times a month

[ ] e. Never or nearly never

4. Has your snoring ever bothered other people?

[ ] a. Yes

[ ] b. No

[ ] c. Don’t know

5. Has anyone noticed that you quit breathing during your sleep?

[ ] a. Nearly every day

[ ] b. 3-4 times a week

[ ] c. 1-2 times a week

[ ] d. 1-2 times a month

[ ] e. Never or nearly never

CATEGORY 2

6. How often do you feel tired or fatigued after your sleep?

[ ] a. Nearly every day

[ ] b. 3-4 times a week

[ ] c. 1-2 times a week

[ ] d. 1-2 times a month

[ ] e. Never or nearly never

7. During your waking time, do you feel tired, fatigued, or not up to par?

[ ] a. Nearly every day

[ ] b. 3-4 times a week

[ ] c. 1-2 times a week

[ ] d. 1-2 times a month

[ ] e. Never or nearly never

8. Have you ever nodded off or fallen asleep while driving a vehicle?

[ ] a. Yes

[ ] b. No

If yes:

9. How often does this occur?

[ ] a. Nearly every day

[ ] b. 3-4 times a week

[ ] c. 1-2 times a week

[ ] d. 1-2 times a month

[ ] e. Never or nearly never

CATEGORY 3

10. Do you have high blood pressure?

[ ] Yes

[ ] No

[ ] Don’t know

Scoring Berlin Questionnaire

The questionnaire consists of 3 categories related to the risk of having sleep apnea. Patients can be classified into high risk or low risk based on their responses to the individual items and their overall scores in the symptom categories.

Categories and scoring:

Category 1: items 1, 2, 3, 4, 5

Item 1: if ’Yes’, assign 1 point

Item 2: if ’c’ or ’d’ is the response, assign 1 point

Item 3: if ’a’ or ’b’ is the response, assign 1 point

Item 4: if ’a’ is the response, assign 1 point

Item 5: if ’a’ or ’b’ is the response, assign 2 points

Add points. Category 1 is positive if the total score is 2 or more points.

Category 2: items 6, 7, 8 (item 9 should be noted separately)

Item 6: if ’a’ or ’b’ is the response, assign 1 point

Item 7: if ’a’ or ’b’ is the response, assign 1 point

Item 8: if ’a’ is the response, assign 1 point

Add points. Category 2 is positive if the total score is 2 or more points.

Category 3 is positive if the answer to item 10 is ’Yes’ OR if the BMI of the patient is greater than 30kg/m2.

(BMI must be calculated. BMI is defined as weight (kg) divided by height (m) squared, i.e., kg/m2).

High risk: if there are 2 or more categories where the score is positive

Low risk: if there is only 1 or no categories where the score is positive

Additional question: item 9 is not scored and should be noted separately.

Protocol Name from Source:

Berlin Questionnaire

Availability:

Publicly available

Personnel and Training Required

None

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered questionnaire

Life Stage:

Adult, Senior

Participants:

The original psychometrics of the Berlin Questionnaire were based on middle-aged adults (age 49 +/- 17 years).

Specific Instructions:

None

Selection Rationale

This protocol is a widely used short set of questions with an algorithm that uses a scoring mechanism to determine risk for sleep apnea.

Language

English

Standards
StandardNameIDSource
Common Data Elements (CDE) Person Sleep Apnea Text 2970224 CDE Browser
Logical Observation Identifiers Names and Codes (LOINC) Resp sleep apnea adult proto 62636-6 LOINC
Derived Variables

None

Process and Review

Expert Review Panel #6 (ERP 6) reviewed the measures in the Respiratory domain.

Guidance from the ERP 6 includes the following:

• Revised descriptions of the measure

Back-compatible: no changes to Data Dictionary

Previous version in Toolkit archive (link)

Source

Netzer, N. C., Stoohs, R. A., Netzer, C. M., Clark, K., & Strohl, K. P. (1999). Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Annals of Internal Medicine, 131, 485-491.

General References

Chiu, H.-Y., Chen, P. Y., Chuang, L. P., Chen, N. H., Tu, Y. K., Hsieh, Y. J., Wang, Y. C., & Guilleminault, C. (2016). Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: A bivariate meta-analysis. Sleep Medicine Reviews. doi: 10.1016/j.smrv.2016.10.004

Protocol ID:

91501

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX091501_Sleep_Apnea_Age PX091501010300 Age. 4 N/A
PX091501_Sleep_Apnea_Asleep_Driving_Frequency PX091501100000 CATEGORY 2 How often does this occur? 4 N/A
PX091501_Sleep_Apnea_Gender PX091501010400 Gender. 4 N/A
PX091501_Sleep_Apnea_Height PX091501010100 Height. 4 N/A
PX091501_Sleep_Apnea_High_Blood_Pressure PX091501110000 CATEGORY 3 Do you have high blood pressure? 4 N/A
PX091501_Sleep_Apnea_Nodded_Asleep_Driving PX091501090000 CATEGORY 2 Have you ever nodded off or fallen asleep while driving a vehicle? 4 N/A
PX091501_Sleep_Apnea_Quit_Breathing_Sleep PX091501060000 CATEGORY 1 Has anyone noticed that you quit breathing during your sleep? 4 N/A
PX091501_Sleep_Apnea_Snore PX091501020000 CATEGORY 1 Do you snore? 4 Variable Mapping
PX091501_Sleep_Apnea_Snore_Bother_Other PX091501050000 CATEGORY 1 Has your snoring ever bothered other people? 4 Variable Mapping
PX091501_Sleep_Apnea_Snore_Frequency PX091501040000 CATEGORY 1 How often do you snore? 4 Variable Mapping
PX091501_Sleep_Apnea_Snore_Loudness PX091501030000 CATEGORY 1 Your snoring is: 4 Variable Mapping
PX091501_Sleep_Apnea_Tired_Fatigued_After PX091501070000 CATEGORY 2 How often do you feel tired or fatigued after your sleep? 4 N/A
PX091501_Sleep_Apnea_Tired_Fatigued_Waking PX091501080000 CATEGORY 2 During your waking time, do you feel tired, fatigued, or not up to par? 4 N/A
PX091501_Sleep_Apnea_Weight PX091501010200 Weight. 4 N/A
Research Domain Information
Measure Name:

Sleep Apnea

Release Date:

November 28, 2017

Definition

This measure identifies people with sleep apnea.

Purpose

Sleep apnea is a serious, potentially life-threatening condition that is far more common than is generally understood. Sleep apnea occurs in all age groups and both genders.

Keywords

Respiratory, snoring, Berlin Questionnaire, respiratory, Pediatric Sleep Questionnaire, PSQ, proprietary