Berlin Questionnaire: Explanation, Mechanism, Interpretation free test

What is the Berlin Questionnaire?

The Berlin Questionnaire is a simple and effective self-assessment tool for detecting the risk of suffering from obstructive sleep apnea syndrome (OSA).

It can be used to identify people likely to have breathing problems during sleep, such as:

• severe snoring,
• respiratory pauses (apneas),
• excessive daytime sleepiness.

How does the Berlin questionnaire work?

Part 1: Snoring and drowsiness

The berlin questionnaire begins by assessing the presence and severity of snoring, as well as any pauses in breathing (apneas) noticed by those around you.

You will have to answer 5 questions about:

• Whether you snore and how often (every day, a few times a week, etc.).
• The intensity of your snoring (light, loud as speech, very loud).
• If your snoring disturbs others around you.
• If anyone has noticed that you stop breathing while you sleep, and how often.

These questions can be used to detect signs of upper airway obstruction during sleep, characteristic of obstructive sleep apnea syndrome (OSA).

Part 2: Fatigue/Sleepiness

This section looks at your level of excessive daytime sleepiness, one of the key symptoms of OSA.

You will be asked:

• If you feel tired or drowsy in the morning after a night's sleep.
• If you feel tired or lack energy during the day.
• If you've ever felt tired or fallen asleep at the wheel.

Significant daytime sleepiness despite adequate sleep duration may indicate nocturnal respiratory disorders that interfere with the restorative quality of sleep.

Part 3: Hypertension and obesity

The final section looks at the cardiovascular risk factors often associated with OSA:

• Presence of arterial hypertension.
• Calculation of body mass index (BMI) to detect overweight or obesity.
• Hypertension and obesity, particularly abdominal obesity, are factors favoring upper airway narrowing during sleep.

Their presence therefore increases the risk of OSA.

Interpreting the questionnaire results

Category 1: snoring and drowsiness

This category is considered positive if you obtain at least 2 responses indicating frequent, intense snoring or noticeable pauses in breathing.

A high score in this section suggests upper airway obstruction during sleep, typical of obstructive sleep apnea syndrome (OSAS).

Category 2: fatigue/sleepiness

If you have at least 2 positive answers concerning:

• excessive daytime sleepiness,
• tiredness despite a good night's sleep,
• involuntary falling asleep.

This category is considered at risk.

Significant daytime sleepiness is a telltale sign of nocturnal respiratory disorders that interfere with the restorative quality of sleep.

Category 3: Hypertension and obesity

This section is positive if you have declared high blood pressure and/or a body mass index (BMI) greater than 30 kg/m², a sign of obesity.

Hypertension and overweight/obesity, particularly abdominal obesity, are factors favoring upper airway narrowing during sleep.

Final score

If you get a positive score (2 or more answers) in 2 or 3 categories, this indicates a high risk of suffering from obstructive sleep apnea syndrome.

A thorough screening and diagnosis by a physician or sleep specialist is then recommended, usually by polysomnography or ventilatory polygraphy.

Limitations and precautions of the Berlin questionnaire

Although the Berlin questionnaire is a valuable tool for screening for the risk of sleep apnea, it has certain limitations of which we must be aware.

Firstly, it is not sufficient in itself to make a definitive diagnosis of obstructive sleep apnea syndrome.

Positive results simply indicate a high risk of suffering from this nocturnal respiratory pathology.

A thorough medical evaluation by a sleep specialist or pulmonologist is essential to confirm or rule out OSA.

The Back2Sleep solution, the intranasal orthosis

For people suffering from mild to moderate sleep apnea, the Back2Sleep intranasal orthosis can represent a treatment solution treatment solution.

This nasal appliance keeps the airways open during sleep, enabling regular, restorative breathing.

FAQ about the Berlin questionnaire

Q. Are there other tests for sleep apnea?

To confirm or rule out this respiratory disorder, further in-depth examinations are required:

• Polysomnography (complete sleep recording) performed in a sleep laboratory remains the gold standard. It analyzes respiratory parameters, eye movements, brain and muscle activity during the night.
• Ventilatory (or respiratory) polygraphy is a simplified test that can be performed at home. It records respiratory effort, oxygen saturation, snoring and thorax/abdomen movements.
• The Epworth Sleepiness Test assesses the level of excessive daytime sleepiness, one of the key symptoms of OSA.
• The sleep diary, kept by the patient, provides additional information on sleep habits and quality.

Your doctor will be able to prescribe these different tests based on the results of the Berlin questionnaire and the initial clinical examination. Don't hesitate to discuss it with him for a reliable diagnosis of OSA.

Q. Is sleep apnea dangerous?

The main complications are:

• Cardiovascular: hypertension, cardiac arrhythmias, strokes, myocardial infarction.
• Metabolic: insulin resistance, type 2 diabetes, metabolic syndrome.
• Cognitive: concentration and memory problems, irritability, depression.
• Excessive daytime sleepiness can lead to accidents on the road or at work.

OSA leads to repeated micro-awakenings during the night, fragmenting restful sleep. The body then undergoes harmful chronic oxidative and inflammatory stress.