STUDY OBJECTIVE: The Berlin Questionnaire and Epworth Sleepiness Scale (ESS) are commonly used to screen for sleep apnea in non-pregnant populations. We sought to evaluate the Berlin and ESS in pregnancy and to determine whether an alternative screening approach could better detect sleep apnea in pregnant women. METHODS: Pregnant women at high risk for sleep apnea (women with chronic hypertension, pre-gestational diabetes, obesity, and/or a prior history of preeclampsia) completed a sleep survey composed of the Berlin and ESS, and participated in an overnight sleep evaluation with the Watch-PAT100 (WP100), a wrist-mounted device designed to diagnose sleep apnea, defined as an apnea hypopnea index ≥ 5. Using multivariable statistics, demographic, clinical, and subjective symptoms that were independently associated with sleep apnea were determined and a prediction rule for the presence of sleep apnea was developed. The predictive capacity of this newly developed system was compared to that of the Berlin and ESS using receiver-operating curve (ROC) statistics. RESULTS: Of the 114 women who participated and had a valid WP100 study, 100 completed the Berlin and 96 the ESS. The Berlin and ESS did not accurately predict sleep apnea in this high-risk pregnancy cohort, with ROC area under the curves (AUC) of 0.54 (p = 0.6) and 0.57 (p = 0.3), respectively. Conversely, a model incorporating frequent snoring, chronic hypertension, age, and body mass index performed significantly better (AUC 0.86, p > 0.001). CONCLUSION: The Berlin and ESS are not appropriate tools to screen for sleep apnea in high-risk pregnant women. Conversely, our four-variable model more accurately predicts sleep apnea in pregnancy.
STUDY OBJECTIVE: The Berlin Questionnaire and Epworth Sleepiness Scale (ESS) are commonly used to screen for sleep apnea in non-pregnant populations. We sought to evaluate the Berlin and ESS in pregnancy and to determine whether an alternative screening approach could better detect sleep apnea in pregnant women. METHODS: Pregnant women at high risk for sleep apnea (women with chronic hypertension, pre-gestational diabetes, obesity, and/or a prior history of preeclampsia) completed a sleep survey composed of the Berlin and ESS, and participated in an overnight sleep evaluation with the Watch-PAT100 (WP100), a wrist-mounted device designed to diagnose sleep apnea, defined as an apnea hypopnea index ≥ 5. Using multivariable statistics, demographic, clinical, and subjective symptoms that were independently associated with sleep apnea were determined and a prediction rule for the presence of sleep apnea was developed. The predictive capacity of this newly developed system was compared to that of the Berlin and ESS using receiver-operating curve (ROC) statistics. RESULTS: Of the 114 women who participated and had a valid WP100 study, 100 completed the Berlin and 96 the ESS. The Berlin and ESS did not accurately predict sleep apnea in this high-risk pregnancy cohort, with ROC area under the curves (AUC) of 0.54 (p = 0.6) and 0.57 (p = 0.3), respectively. Conversely, a model incorporating frequent snoring, chronic hypertension, age, and body mass index performed significantly better (AUC 0.86, p > 0.001). CONCLUSION: The Berlin and ESS are not appropriate tools to screen for sleep apnea in high-risk pregnant women. Conversely, our four-variable model more accurately predicts sleep apnea in pregnancy.
Authors: Sofia A Olivarez; Bani Maheshwari; Meghan McCarthy; Nikolaos Zacharias; Ignatia van den Veyver; Lata Casturi; Haleh Sangi-Haghpeykar; Kjersti Aagaard-Tillery Journal: Am J Obstet Gynecol Date: 2010-02-20 Impact factor: 8.661
Authors: Susan Redline; Gayane Yenokyan; Daniel J Gottlieb; Eyal Shahar; George T O'Connor; Helaine E Resnick; Marie Diener-West; Mark H Sanders; Philip A Wolf; Estella M Geraghty; Tauqeer Ali; Michael Lebowitz; Naresh M Punjabi Journal: Am J Respir Crit Care Med Date: 2010-03-25 Impact factor: 21.405
Authors: Francesca L Facco; William A Grobman; Jamie Kramer; Kim H Ho; Phyllis C Zee Journal: Am J Obstet Gynecol Date: 2010-05-26 Impact factor: 8.661
Authors: Nathaniel S Marshall; Keith K H Wong; Craig L Phillips; Peter Y Liu; Matthew W Knuiman; Ronald R Grunstein Journal: J Clin Sleep Med Date: 2009-02-15 Impact factor: 4.062
Authors: K M Antony; A Agrawal; M E Arndt; A M Murphy; P M Alapat; K K Guntupalli; K M Aagaard Journal: J Perinatol Date: 2014-03-06 Impact factor: 2.521