Current Knowledge/Study Rationale: Several validated questionnaires are available for screening for obstructive sleep apnea but none has sufficient sensitivity or specificity to mitigate the need for further clinical assessment and testing. Level III portable monitors, while tending to underestimate sleep apnea severity, provide an objective assessment of sleep apnea severity that is often adequate for clinical decision-making. This study evaluated whether one or more previously validated questionnaires, or a combination of these questionnaires with the results from a Level III study, could mitigate the need for polysomnography in patients referred to a sleep disorders clinic.
Study Impact: The results demonstrate that the questionnaires were inferior to the Level III study in determining the presence or absence of sleep apnea, and when combined with the information from the Level III study, did not enhance its discriminant ability. These finding strongly suggest that objective physiological monitoring is critically important in the diagnosis and exclusion of obstructive sleep apnea, and cannot be supplanted by questionnaire data.