Sleep questionnaires for the screening of obstructive sleep apnea in patients with type 2 diabetes mellitus compared with non-diabetic patients

J Diabetes. 2019 Mar;11(3):214-222. doi: 10.1111/1753-0407.12835. Epub 2018 Sep 10.

Abstract

Background: Several tools have been used to screen for obstructive sleep apnea (OSA). Evaluation of the predictive performance of different questionnaires is essential in patients with type 2 diabetes mellitus (T2DM) because the prevalence of OSA in this population is high. The aim of this study was to evaluate different sleep questionnaires to identify T2DM patients with OSA, and to compare the predictive values of these questionnaires with a matched sample of non-diabetic patients.

Methods: The study was a retrospective study of two patients groups (n = 350 with T2DM, n = 350 without T2DM) visiting a sleep clinic and matched by age, gender, body mass index, and the apnea-hypopnea index (AHI). Symptoms of OSA and Epworth Sleepiness Scale (ESS), STOP-Bang, Berlin questionnaire, and Athens insomnia scale (AIS) scores were compared, and sleep studies were performed.

Results: Diabetic patients with OSA complained more frequently of nocturia (P = 0.025), morning headaches (P = 0.04), restless sleep (P = 0.002), and leg movements (P = 0.01) than non-diabetic patients with OSA. Most predictive values of the sleep questionnaires did not differ significantly between the two groups; however, the AIS was higher only in T2DM women (P = 0.01). In both groups, the Berlin and STOP-Bang questionnaires had the highest sensitivity. The ESS had the highest specificity in T2DM patients and the STOP and S-B questionnaires had the highest specificity in non-diabetics.

Conclusions: The predictive performance of the questionnaires was similar in both groups, especially in the case of moderate and severe OSA.

Keywords: Athens insomnia scale; Berlin questionnaire; Epworth Sleepiness Scale; Epworth嗜睡评分量表; STOP-Bang; STOP-Bang问卷; diabetes; 柏林问卷; 糖尿病; 雅典失眠量表.

MeSH terms

  • Body Mass Index
  • Case-Control Studies
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Female
  • Greece / epidemiology
  • Humans
  • Male
  • Mass Screening*
  • Middle Aged
  • Polysomnography
  • Prevalence
  • Retrospective Studies
  • Sleep Apnea, Obstructive / diagnosis*
  • Sleep Apnea, Obstructive / epidemiology*
  • Surveys and Questionnaires