The Epworth Sleepiness Scale in Service Members with Sleep Disorders

Hurlston, A; Foster, Shannon N; Creamer, Jennifer; Brock, Matthew S; Matsangas, Panagiotis; Moore, Brian A; Mysliwiec, Vincent

doi:10.1093/milmed/usz066

Cited by 21 publications

(14 citation statements)

References 33 publications

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“…The study supports the body of evidences that similarly show that ESS is not a good predictor of the presence of sleep apnea [22,[41][42][43] and less emphasis should be placed on it when determining whether PSG should be performed in patients suspected of having sleep breathing disorder. with screening questionnaires and the Epworth sleepiness scale.…”

Section: Discussionsupporting

confidence: 83%

The Predictive Value of Epworth Sleepiness Scale in Obstructive Sleep Apnea

Alabi¹,

Alabi²

2019

J Sleep Disord Ther

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Background: The Epworth sleepiness score is a vital tool clinicians use to grade the severity of excessive daytime sleepiness and it is also given significant relevance by the third-party payers before approving Continuous Positive Airway Pressure (CPAP) treatment for patients with obstructive sleep apnea with apnea-hypopnea index between 5 to 15 events per hour. Many studies that explored if an elevated Epworth sleepiness score can predict the presence of obstructive sleep apnea have had conflicting results. Whereas some show association between Epworth sleepiness score and obstructive sleep apnea, others did not find any association. In this study, the association of Epworth sleepiness score with obstructive sleep apnea was evaluated at a community-based practice with multiple locations all around central Florida. We also analyzed the association of apnea-hypopnea index with known risk factors for obstructive sleep apnea such as larger neck circumference, overweight and obesity. Methods: In this cross-sectional study, we reviewed the charts of 529 consecutive subjects who presented for sleep evaluation at a community practice over a period of 6 months and underwent sleep studies. 186 (35%) of the patients were not included in our analysis because they have incomplete data. 343 patients were used for this data analysis and 252 (73.5%) were diagnosed with sleep apnea based on apnea-hypopnea index of ≥5 per hour on polysomnography. The following data were collected on each subject; body-mass-index, neck circumference, Epworth sleepiness score, the absence or presence of excessive daytime sleepiness, hypertension and diabetes. Epworth sleepiness score ≥10 was considered elevated while large neck circumference was set at ≥16 inches in females and ≥17 inches in males. Results: 252 patients had sleep apnea, 94.8% of them were overweight or obese, 84.1% had large neck circumference, 82.1% presented with excessive daytime sleepiness, 63.1% had hypertension, 34.1% had diabetes and 57.5% had an elevated Epworth sleepiness score. Pearson's tests between body-mass-index and apnea-hypopnea-index in the overweight and obese patients showed positive correlation (P<0.001, R=0.24, N=319). Furthermore, the relationship between neck circumference and apnea-hypopnea-index in males with neck circumference of ≥17 inches was significant with positive correlation (P=0.047, R=0.17, N=143) likewise, in females with neck circumference ≥16 inches, the relationship was also significant (P<0.001, N=128) with a stronger correlation (R=0.32) but the association between Epworth sleepiness score and AHI was not significant (P=0.79, R=0.02, N=193). Interestingly, a significant positive correlation coefficient (R=0.39, P=0.02) was seen between BMI and AHI in the population of males who were overweight, hypertensive and diabetic. The same relationship was not significant in females (P=0.1). Conclusion: In this study, BMI in overweight patients and large neck circumference has positive correlation with apnea-hypopnea-index but no significant associa...

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Section: Discussionsupporting

confidence: 83%

The Predictive Value of Epworth Sleepiness Scale in Obstructive Sleep Apnea

Alabi¹,

Alabi²

2019

J Sleep Disord Ther

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“…Each item of the ESS was scored from 0 to 3, and the total scores ranged from 0 to 24. A higher ESS score means that patients have higher sleep propensity in daily life [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

Polysomnography and Nocturia Evaluations after Uvulopalatopharyngoplasty for Obstructive Sleep Apnea Syndrome

Tsou

Chou

Shie

et al. 2020

JCM

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A higher incidence rate of nocturia in patients with obstructive sleep apnea (OSA) has been observed. We investigated the differences in clinical examinations between OSA patients with and without nocturia, and further compared those with successful and unsuccessful uvulopalatopharyngoplasty (UPPP). This retrospective study enrolled 103 patients with OSA undergoing UPPP. Patients were diagnosed with OSA by following the 2018 American Academy of Sleep Medicine (AASM) Scoring Manual Version 2.5. Patients were divided into two groups depending on if they urinated more than twice per night. The medical data of body mass index (BMI), nocturia frequency per night, apnea–hypopnea index (AHI), Epworth Sleepiness Scale (ESS), International Prostatic Symptom Score (IPSS), and Overactive Bladder Symptom Score (OABSS) were analyzed before and after uvulopalatopharyngoplasty (UPPP) surgery. All of the measurements were compared between successful and unsuccessful surgery in the non-nocturia or nocturia groups, respectively. Fifty patients (41 males and nine females) without nocturia were assigned to group 1, and 53 patients (43 males and 10 females) with nocturia were assigned to group 2. Nocturia frequency and post-surgery AHI in group 2 were significantly higher than those in group 1 (p < 0.05). Significant decreases in IPSS and OABSS were observed in the successful surgery subgroup of group 2 (p < 0.05). A significant decrease in post-surgery AHI was observed between unsuccessful and successful surgery in patients with nocturia (p < 0.05), but not in the non-nocturia group (p > 0.05). Although AHI had a significant correlation to nocturia frequency in all OSA patients before UPPP, no significant correlation between AHI reduction and nocturia frequency was found. UPPP appeared to be an effective treatment for nocturia associated with OSA. OSA should be taken into consideration for patients who complain of nocturia syndrome. The relationship of AHI reduction and nocturia improvement after OSA treatment with UPPP is still unclear. In addition, it is necessary to establish the existence of nocturia in patients with OSA, as a result of its high prevalence in OSA patients. UPPP could reduce the symptoms of OSA and could also contribute to a reduction of nocturia even in the unsuccessful surgery group.

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“…Full history had been taken, in presence of the bed partner with focusing on OSA manifestation i.e. daytime sleepiness which analyzed by Epworth Sleepiness Scale [ESS] [17] . Full ENT examination included nasal, nasopharyngeal, oro-pharyngeal and hypopharyngeal examination.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of Modified Hyoid Bone Suspension Technique Compared to Midline Glossectomy in Management of Hypopharyngeal Obstruction in Obstructive Sleep Apnea Patients

Refaat

2020

International Journal of Medical Arts

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Background: Obstructive sleep apnea (OSA) is a common and challenging health problem, especially in adults, as it is the second most common disease related to sleep. Surgical treatment plays an important role in management of OSA. However, the optimal procedure is not yet determined. Aim of the work: To compare between modified hyoid bone suspension and midline glossectomy in management of OSA due to hypopharyngeal obstruction. Patients and Methods: 40 patients with OSA due to hypopharyngeal obstruction were randomly assigned to either modified hyoid bone suspension (group A; 20 patients) or midline glossectomy (group B; 20 patients). All had been assessed by full history, clinical examination and Lab investigations and underwent pre-assigned surgical intervention. Indicators of OSA such as minimal oxygen saturation, Apnea hypopnea Index [AHI] and Epworth Sleepiness Scale [ESS] had been measured preoperatively and 6 months after surgery. Results: The studied groups were comparable as patient characteristics and preoperative data. However, hyoid suspension was associated with significant decrease of AHI [16.67±6.06 vs 20.72±4.41] and ESS [9.10±2.42 vs 11.20±2.33]. Also, minimal oxygen saturation improved significantly in group A than group B. The percentage of responders increased significantly in group A (75.0% vs 40.0% respectively). Conclusion: Modified hyoid suspension is superior than the midline glossectomy, as a safer and more effective procedure for treatment of OSA due to hypopharyngeal obstruction.

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The Epworth Sleepiness Scale in Service Members with Sleep Disorders

Cited by 21 publications

References 33 publications

The Predictive Value of Epworth Sleepiness Scale in Obstructive Sleep Apnea

The Predictive Value of Epworth Sleepiness Scale in Obstructive Sleep Apnea

Polysomnography and Nocturia Evaluations after Uvulopalatopharyngoplasty for Obstructive Sleep Apnea Syndrome

Efficacy of Modified Hyoid Bone Suspension Technique Compared to Midline Glossectomy in Management of Hypopharyngeal Obstruction in Obstructive Sleep Apnea Patients

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