Adaptation of the Berlin Questionnaire for Geriatric Assessment

Rationale:

The Berlin Questionnaire is a beneficial screening tool for the probability of obstructive sleep apnea syndrome (OSAS) risk. However, its original version is not suitable for elderly persons due to the inapplicability of several questionnaire items and may need adjustments.

Methods:

Within the International Geriatric Sleep Medicine Task Force the original version of the Berlin Questionnaire was critically discussed. Four items were found to be unsuitable for the assessment of sleep apnea in geriatric patients and were changed accordingly: Weight change and moderate obesity don't play a major role in the elderly as OSAS risk factor. Because of reduced automobile use in elderly > 75yrs, the falling asleep while driving question is inappropriate. Presence of daytime high blood pressure alone in the elderly is no specific risk factor for SAS, high blood pressure peaks in the morning might well be.

Results:

Weight gain is excluded from the scoring system, but calculations of the BMI still remain in the section of anthropometric data now without scoring for risk. Category 1 (snoring/apneas) remains unchanged. In category 2 (excessive daytimes sleepiness) the question determining how many times the patient nods off while driving a vehicle is replaced. Instead, sleepiness during communicational involvement, e.g., talking to friends and relatives or while playing with grandchildren is assessed. Category 3 (comorbidities) now consists of two new questions asking for high blood pressure in the morning and presence of nocturia. The scoring within all three categories and for overall risk remains unchanged.

Conclusion:

The new geriatric version of the Berlin Questionnaire is adapted for geriatric assessment. A validation study has started.