Dear Editor,

We read carefully the article prepared by Grillo PM et al. (2023), entitled “Obstructive sleep apnea syndrome risk in patients with non-alcoholic fatty liver disease is associated with obesity and presence of nash”, published by their prestigious journal.

In the study they used the Berlin Questionnaire (BQ), for the diagnosis of Chronic Obstructive Sleep Apnea Syndrome (OSAS) obtaining reliability in the results¹1. Grillo PM, Punaro GR, Elias MC, Parise ER. Obstructive sleep apnea syndrome risk in patients with non-alcoholic fatty liver disease is associated with obesity and presence of Nash. Arq Gastroenterol. 2022;59:251-6., however, the polysomnography instrument that is the Gold Standard could have given more specific results as mentioned in the article published by Pablo AV and collaborators, in which it is evident that the BQ evaluates clinical manifestations, while Polysomnography evaluates various physiological variables of sleep among others²2. Pablo AV, Laura OP, Nathalia CB, Victor PR, Paul AC. Analysis view of various polysomnographic variables and their relationship with the severity of obstructive sleep apnea and hypoapnea syndrome. [Internet]. Org.co. Available from: https://www.revista.acorl.org.co/index.php/acorl/article/view/512/435
https://www.revista.acorl.org.co/index.p... .

The BQ is a fast and low-cost tool, however, for the study the STOP-Bang questionnaire could have been used, which has similar characteristics and according to Franklin E et al. it is a tool of greater sensitivity³3. Franklin E, Eslava-Schmalbach J. Evaluation of obstructive sleep apnea-hypopnea syndrome (OSAHS) using measuring instruments such as scales and mathematical formulas. Rev fac med univ nac colomb [Internet]. 2017;65(1Sup):57-90. Available from: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-00112017000500087
http://www.scielo.org.co/scielo.php?scri... .

In addition, with the BQ there is a high probability of obtaining false or erroneous answers from the patients surveyed because it is a self-administered method⁴4. Pelayo Varela C, Lozano Iragüen P, Benavides Simon E. Sleep Apnea-Hypoapnea Syndrome (OSAHS) as a perioperative risk factor: Clinical relevance and role of the anesthesiologist in pre-surgical evaluation. Rev Chil Anest [Internet]. 2018;47:102-9. Available from: https://revistachilenadeanestesia.cl/PII/revchilanestv47n02.07.pdf
https://revistachilenadeanestesia.cl/PII... .

In conclusion, polysomnography is an instrument of greater reliability with respect to OSAS because it is the gold standard, therefore when used it would have led to give greater quality to the research, as well as the usefulness of the Stop Bang could have given greater sensitivity in the results.

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