Excessive daytime sleepiness assessed by the Epworth Sleepiness Scale and its association with health related quality of life: a population-based study in China

Abstract

BackgroundExcessive daytime sleepiness (EDS) is a common condition worldwide that has many negative effects on people who were afflicted with it, especially on their health-related quality of life (HRQOL). The Epworth Sleepiness Scale (ESS) is a commonly used method for evaluating EDS in English-speaking countries. This paper reported the prevalence of subjective EDS in China as assessed by the Mandarin version of the ESS; tested the scale’s response rate, reliability and validity; and investigated the relationship between ESS scores and HRQOL.MethodsA population-based sample of 3600 residents was selected randomly in five cities in China. The demographic information was collected, subjective EDS was assessed by the Mandarin version of the ESS (ESS scores >10), and HRQOL was evaluated by the Mandarin version of the 36-item Short Form Health Survey (SF-36).ResultsThe Mandarin version of ESS had very few missing responses, and the average response rate of its eight items was 97.92%. The split-half reliability coefficient and Cronbach’s α coefficient were 0.81 and 0.80, respectively. One factor was identified by factor analysis with an eigenvalue of 2.78. The ESS scores showed positive skewness in the selected sample, with a median (Q1, Q3) of 6 (3, 0). 644 (22.16%) respondents reported subjective EDS, and all of the scores of the eight dimensions of the SF-36 were negatively correlated with ESS scores.ConclusionsThe Mandarin version of ESS is an acceptable, reliable, and valid tool for measuring EDS. In addition, subjective EDS is common in China, based on the ESS results, and impairs HRQOL.

Asthma outcomes improve with continuous positive airway pressure for obstructive sleep apnea

“…On the other hand, in patients with OSAS, it has been observed a significant difference after using sham‐CPAP both in the degree of daytime hypersomnia and in several polysomnographic parameters: While hypersomnia improved 42, the quality of the sleep became worse (decreased sleep efficiency, increased time in stage 1 NREM sleep, and prolonged latency to REM sleep) 43. Therefore, taking into account the existing correlations between sleep quality, daytime hypersomnia, quality of life, and asthma control 44, 45, and the potential effect of sham‐CPAP in BHR 34, it cannot be excluded that subtherapeutic CPAP pressures, used as a placebo in asthmatic patients with OSAS, may have relevant effects on asthma outcomes that would distort the results of a controlled study. Finally, there are ethical issues regarding keeping patients with OSAS without active treatment, in patients with two potentially severe diseases.…”

Association Between Excessive Daytime Sleepiness and Functional Gastrointestinal Disorders: A Population-based Study in China

“…20 The Chinese version of ESS, modified Chinese version of the Rome II questionnaire (gastroduodenal, bowel, and biliary items only) and the Chinese version of Reflux Disease Questionnaire (RDQ) were applied to measure EDS, FGIDs, and GERD. 6,16,[21][22][23] The ESS is an 8-item, self-administered questionnaire covering eight situations commonly encountered in daily life. Each participant was instructed to answer how likely it is that he/she would fall asleep in different situations by giving a score ranging from 0 to 3.…”

“…18 EDS is a common sleep-related symptom in China, it is more prevalent in the general Chinese population (22.2%) than in general American (8.7%) and Japanese populations (2.5%). [4][5][6] It is of interest whether EDS was associated with FGIDs. However, the relationship between EDS and FGIDs in the general population has not been systematically studied, especially in China.…”

“…Prevalence of EDS in the general population varies among different countries ranging from 2.5% to 22.2%. [1][2][3][4][5][6] EDS can result in psychosocial distress, decreased work or school performance, impairment of health-related quality of life (HRQOL), and higher risk for accidents and occupational injuries. [6][7][8] Besides common causes of EDS such as sleep deficiencies, drugs, depression and migraines, obesity, diabetes, and ulcers were also supposed to be significantly associated with EDS.…”

“…[1][2][3][4][5][6] EDS can result in psychosocial distress, decreased work or school performance, impairment of health-related quality of life (HRQOL), and higher risk for accidents and occupational injuries. [6][7][8] Besides common causes of EDS such as sleep deficiencies, drugs, depression and migraines, obesity, diabetes, and ulcers were also supposed to be significantly associated with EDS. 4,9 It was reported that sleep problems, such as sleep impairment, sleep disorders, and sleep disruption were associated with functional gastrointestinal disorders (FGIDs), such as functional dyspepsia (FD) and irritable bowel syndrome (IBS).…”