Crtical Care and Shock Journal

Berlin Questionnaire and Portable Monitoring Device for Diagnosing Obstructive Sleep Apnea: A Preliminary Study in Jakarta, Indonesia



Study objective: to evaluate patients who came with the history of snoring with Berlin Questionnaire and sleep study using portable monitoring device.

Setting: Mitra International Hospital, Jakarta, Indonesia.

Material and methods : This was a preliminary study in 15 patients who came to the Respiratory Clinic with the history of snoring and suspicion of having obstructive sleep apnea (OSA). They were intended to undergo a sleep study using a portable device (PM). All patients were screened with Berlin Questionnaire and continued with application of portable monitoring device for one night stay at the hospital. Parameters recorded during examination were body mass index (BMI), apnea/hypopnea index (AHI), oxygen saturation, oxygen desaturation during sleep and lowest oxygen desaturation during sleep.

Results: There were 14 (93.3%) male and only 1 female (6.7%) joined the study; the mean age was 48.93 year old, with age ranged between 16-74 year old. Only 2 patients with BMI 18-23 and 13 others had BMI ³23. Three patients were not assessed by Berlin Questionnaire, 1 patient was disconnected from oxygen accidentally during sleep. From 12 patients screened with Berlin Questionnaire, 9 patients (75%) had high risk and 3 patients (25%) had low risk. Based on AHI, there were 4 patients with AHI £5, 3 patients with mild OSA (AHI 5-15), 3 patients with moderate OSA (AHI 15-30), and 5 patients had severe OSA (AHI >30).

Oxygen saturation recorded by pulse oxymeter (SpO2) ranged between 81.6% to 98.0%, while the lowest SpO2 during sleep ranged between 68.0% to 89.1%. Oxygen desaturation (OD) ranged between 4.40% to 9.40%.

Only 4 patients (2 moderate OSA, 2 severe OSA) can be followed of using continuous positive airway pressure (CPAP) machine after the test. There was improvement in patient using CPAP. In patients with severe OSA, AHI improved to 5-15, while in moderate OSA AHI was improved to <5.

Conclusion : Berlin Questionnaire is quite reliable to determine which patient need further evaluation of OSA and portable monitoring device may be used for diagnosing sleep apnea since in 4 patients with moderate (AHI 15-30) and severe OSA (AHI >30) were all improved with CPAP. Based on this preliminary study, portable monitoring device can be used in the situation where no sleep laboratory available or in patient refused to be assessed with attended full polysomnography.

Menaldi Rasmin


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