Can We Reduce the Diagnostic Burden of Sleep Disorders? A-Single Centre Study of Subjective and Objective Sleep-Related Diagnostic Parameters

Sleep disorders are highly prevalent in society and require focused attention within healthcare systems. While patient history, reported complaints, and subjective sleep questionnaires can provide initial insights into the potential sleep issues, polysomnography (PSG) remains the gold standard for diagnosing various sleep disorders. However, long waiting times for PSG appointments in many healthcare facilities pose challenges for timely diagnosis and treatment. This study aimed to evaluate the diagnostic value of subjective measures, including patient-reported parameters, in comparison to the objective findings of PSG. This study included 562 patients who underwent clinical evaluation and PSG testing at the Hospital of Lithuanian University of Health Sciences Kaunas Clinics between 2018 and 2024. We report diagnostic accuracy of different sleep questionnaires (Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Berlin Questionnaire (BQ), Ullanlina Narcolepsy Scale (UNS), Innsbruck REM Sleep Behaviour Disorder Inventory (RBD-I), REM Sleep Behaviour Disorder Single-Question Screen (RBD1Q), Paris Arousal Disorders Severity Scale (PADSS)) to detect various sleep disorders in our population. When comparing our findings with previous literature, we found that the screening tools generally demonstrated slightly lower performance in our population. However, our results suggest that certain individual questions from comprehensive questionnaires may provide comparable diagnostic value while reducing patient burden. We propose a targeted screening approach that integrates fundamental clinical parameters, key screening questions, and selected validated questionnaires, enabling primary care and outpatient clinicians to more efficiently identify patients who may require referral for specialized sleep evaluation and treatment.