Questionnaires to predict the presence of OSA

Below is a series of commonly used questionnaires that have been developed to predict the presence of OSA based on symptoms, signs and measurements. Although they have some success, they are neither satisfactorily sensitive nor specific enough to be a substitute for objective measurement of the presence of sleep disordered breathing by a sleep study.

The Epworth sleepiness scale (ESS) is a simple, eight-item questionnaire that measures a person’s current propensity to fall asleep in various situations. The ESS is the most widely used, quantifiable assessment of sleepiness for both patient and partner (separately).

The Epworth sleepiness scale adapted for children and adolescents.

The Berlin Questionnaire is used to identify patients with sleep apnoea in the general population, primary care and sleep clinic settings. The categories are snoring severity, excessive daytime sleepiness, history of high blood pressure or obesity.

STOPBANG determines risk for sleep apnoea and predicts risk of post-operative complications in individuals with sleep apnoea.

The Stanford Sleepiness Scale is a seven point, self rating scale that has descriptors ranging from “feeling active, vital alert, or wide awake” (score = 1) to “no longer fighting sleep, sleep onset soon and having dream-like thoughts” (score = 7) which is useful to quantify sleepiness at certain points in time.

The OSA-50 is a self scoring questionnaire for patients to assess the likelihood that they have Obstructive Sleep Apnoea using 4 questions (waist circumference, snoring habits, witnessed apnoeas and age).

Functional Outcomes of Sleep Questionnaire is a quality of life questionnaire to determine functional status in adults; measures are designed to assess the impact of disorders of excessive sleepiness on activities of everyday living and the extent to which these abilities are improved by effective treatment. The questionnaire rates the difficulty of performing a given activity on a 4 point scale (no difficulty to extreme difficulty).

A screening tool is necessary to stratify patients based on their clinical symptoms, their physical examinations, and their risk factors, in order to ascertain patients at high risk and in urgent need of further investigation, or alternatively for those at low risk who may not need an overnight sleep study.

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© Institute of Clinical Science and Technology (ICST) 2020