Original Article Might the Berlin Sleep Questionnaire applied to bed partners be used to screen sleep apneic patients? Patricia Sagaspe a,b , Damien Leger c , Jacques Taillard a,d , Virginie Bayon a , Guillaume Chaumet a,e , Pierre Philip a,d,e,f, * a GENPPHASS, CHU Pellegrin, Bordeaux, France b LEPSIS, INRETS-LCPC, Paris, France c Hôpital Hôtel-Dieu, Paris, France d CNRS UMR-5227, Bordeaux, France e Université Bordeaux 2, Bordeaux, France f Clinique du Sommeil, CHU Pellegrin, Bordeaux, France article info Article history: Received 31 August 2009 Received in revised form 25 January 2010 Accepted 31 January 2010 Available online 3 April 2010 Keywords: Sleep questionnaire Screening Obstructive sleep apnea syndrome (OSAS) Stroke Diagnosis Bed partner abstract Objective: While the Berlin Sleep Questionnaire (BSQ) was developed to identify patients at high risk of having sleep apnea, assessment can be difficult in patients suffering from impaired cognitive functions (i.e., stroke patients). We therefore created a modified version of the questionnaire to be used in patients’ bed partners to test whether it could give identical results to the original form of BSQ. Methods: The BSQ was filled in by 90 patients hospitalized in our Sleep Clinic for polysomnographic recording and by 33 healthy control subjects recorded polysomnographically. An adapted version of the BSQ was completed by each bed partner. Results: Sixty of the 123 subjects had a Respiratory Disturbance Index (RDI) > 5 and 49.6% of them were classified as being at high risk of having sleep apnea with both questionnaires. Being in the high-risk group with the self-reported Berlin questionnaire predicted an RDI > 15 with a sensitivity of 0.76 and a specificity of 0.61 versus a sensitivity of 0.82 and a specificity of 0.63 with the bed-partner Berlin ques- tionnaire. Being in the high-risk group with the self-reported Berlin questionnaire predicted an RDI > 30 with a sensitivity of 0.71 and a specificity of 0.53 versus a sensitivity of 0.79 and a specificity of 0.54 with the bed-partner Berlin questionnaire. Conclusions: The bed-partner Berlin questionnaire predicts an RDI > 15 with a better sensitivity and spec- ificity than the original questionnaire. It could, therefore, be used in bed partners of patients suspected of obstructive sleep apnea syndrome who cannot fill in the self-reported Berlin questionnaire. Ó 2010 Elsevier B.V. All rights reserved. 1. Introduction Obstructive sleep apnea syndrome (OSAS) affects 5% of the gen- eral population and seems to be more widespread in primary care practice [1,2]. The consequences of its morbidity and mortality are now well documented, especially with regard to cardio and cere- brovascular diseases. Sleep-disordered breathing is independently associated with hypertension in both men and women [3–5]. Re- cent studies have also demonstrated a high prevalence of OSAS among stroke patients. An association exists between moderate- to-severe sleep-disordered breathing and prevalence of stroke independently of confounding factors [6,7]. Hypoxemia and hemo- dynamic responses to obstructive sleep apnea may also predispose patients to stroke and type 2 diabetes [8–11]. It therefore seems important to screen sleep apnea in targeted groups of subjects, i.e., stroke patients, because sleep apnea is a potential risk factor. Although polysomnography is recommended by the sleep inter- national diagnosis consensus task force [12], its availability may be limited, so specific questionnaires can be useful for identifying pa- tients having a suspicion of sleep apnea syndrome. The Berlin Sleep Questionnaire is a recognized self-reported Berlin questionnaire which has been designed to identify patients with a high risk of OSAS [13,14]. But it is sometimes difficult for patients to assess their symp- toms accurately (i.e., snoring loudly during sleep), and the conse- quences of stroke, i.e., speech difficulties, can reduce their ability to fill in sleep questionnaires [15,16]. Therefore, we hypothesized that bed partners might be more apt to witness snoring and sleepiness than patients themselves 1389-9457/$ - see front matter Ó 2010 Elsevier B.V. All rights reserved. doi:10.1016/j.sleep.2010.01.007 * Corresponding author. Address: Université Bordeaux 2, CNRS UMR-5227, GENPPHASS et Clinique du Sommeil (CHU Pellegrin), Place Amélie Raba-Léon, 33076 Bordeaux Cedex, France. Tel.: +33 5 57 82 01 73; fax: +33 5 57 82 00 38. E-mail address: pr.philip@free.fr (P. Philip). Sleep Medicine 11 (2010) 479–483 Contents lists available at ScienceDirect Sleep Medicine journal homepage: www.elsevier.com/locate/sleep