The utility of patient-completed and partner-completed Epworth Sleepiness Scale scores in the evaluation of obstructive sleep apnea

Bhat, Sushanth; Upadhyay, Hinesh; DeBari, Vincent A.; Ahmad, Maqbool; Polos, Peter; Chokroverty, Sudhansu

doi:10.1007/s11325-016-1370-8

Cited by 21 publications

(18 citation statements)

References 52 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%

“…In addition to the risk factors mentioned above, the Epworth sleepiness scale that was developed to subjectively grade the severity of excessive daytime somnolence has been shown by some studies to be predictive of the presence of obstructive sleep apnea [18][19][20]. Some other studies however found it not predictive of obstructed sleep apnea [21][22][23][24]. The Epworth sleepiness scale is a selfadministered questionnaire asking how likely a patient is to doze off while engaging in 8 different activities during daytime and each answer gets a score between 0 and 3 (with the number increasing with severity).…”

Section: Introductionmentioning

confidence: 99%

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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%

Section: Introductionmentioning

confidence: 99%

The Predictive Value of Epworth Sleepiness Scale in Obstructive Sleep Apnea

Alabi¹,

Alabi²

2019

J Sleep Disord Ther

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“…Why then should the ESS fail to correlate with measures of SDB, when SDB is known to cause daytime sleepiness in the general population? A possibility is that ESS is subjective, and patients’ estimation of their own degree of sleepiness can be influenced by factors such as being accustomed to chronic fatigue, disease denial, or employment pressure, particularly for commercial drivers [18, 19]. Another possibility is that patients with ESKD interpret the ESS questions in a manner that mitigates against sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of sleep-disordered breathing in haemodialysis patients

et al. 2019

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Background Sleep-disordered breathing (SDB) is common in patients with kidney disease; but often underdiagnosed as it is infrequently assessed in clinical practice. The objective of this study was to assess the risk factors of SDB in haemodialysis patients, and to identify useful assessment tools to detect SDB in this population. Methods We used nocturnal oximetry, Epworth Sleepiness Scale (ESS) and STOPBANG questionnaire to screen for SDB in haemodialysis patients. Presence of SDB was defined by Oxygen desaturation index (ODI≥5/h), and further confirmed by apnoea-hypopnea index (AHI) from an in-laboratory polysomnography. Blood samples were collected prior to commencing a haemodialysis treatment. Results SDB was detected in 70% of participants (N = 107, mean age 67 years). STOPBANG revealed that 89% of participants were at risk of SDB; however, only 17% reported daytime sleepiness on the ESS. Of the participants who underwent polysomnography (n = 36), obstructive sleep apnoea was identified in 86%, and median AHI was 34.5/h. Oximetry and AHI results were positively correlated (r = 0.62, P = 0.0001), as were oximetry and STOPBANG (r = 0.48; P<0.0001), but not ESS (r = 0.19; P = 0.08). Multivariate analysis showed that neck circumference (OR: 1.20; 95% CI: 1.07–1.34; P = 0.02) and haemoglobin (OR: 0.93; 95% CI: 0.88–0.97; P = 0.003) were independently associated with the presence of SDB. Conclusion Dialysis patients with a large neck circumference and anaemia are at risk of SDB; using nocturnal oximetry is practical and reliable to screen for SDB and should be considered in routine management of dialysis patients, particularly for those who demonstrate risk factors.

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“…Em vista disso, optou-se por usar um limiar de 10 pontos para classificar os professores como tendo sonolência diurna excessiva, já que esse escore é amplamente utilizado em outros estudos 31 .…”

Section: Discussionunclassified

Sonolência diurna excessiva e qualidade de vida relacionada à saúde dos professores universitários

Amaro

Dumith

2018

J. bras. psiquiatr.

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RESUMO Introdução Problemas relacionados ao sono interferem na qualidade de vida das pessoas. Este trabalho tem o objetivo específico de analisar a influência da sonolência diurna excessiva na qualidade de vida dos docentes. Métodos Para tal pesquisa, aplicaram-se três questionários. Para avaliar a qualidade de vida, usou-se o questionário Medical Outcomes Study 36 – Item Short – Form Health Survery. O sono foi avaliado pela escala de Epworth e as demais variáveis foram avaliadas por um questionário semiestruturado, unificado on-line, transcrito no Google Doc. Resultados Dos 688 docentes convidados a participar da pesquisa, 40% responderam ao questionário, compondo a amostra do estudo. Dessa amostra, 35,2% apresentaram sonolência diurna excessiva (IC 95%, 29,5-40,9). Houve associação estatisticamente significativa (p < 0,05) entre a sonolência diurna excessiva com menor escore de qualidade de vida em todos os oito domínios avaliados (capacidade funcional, aspectos físicos, dor, estado geral da saúde, vitalidade, aspectos sociais, aspecto emocional e saúde mental). Conclusão Este trabalho aborda um importante aspecto, com relação direta sobre a qualidade de vida, que se refere ao sono dos indivíduos. A partir desse levantamento, podem ser planejadas medidas para que os escores de qualidade de vida dos docentes sejam incrementados.

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The utility of patient-completed and partner-completed Epworth Sleepiness Scale scores in the evaluation of obstructive sleep apnea

Abstract: Neither patient-completed nor partner-completed ESS scores by themselves have great utility in identifying OSA or predicting its severity. However, taking both scores into consideration together improves the sensitivity and specificity of the screening process.

Cited by 21 publications

References 52 publications

The Predictive Value of Epworth Sleepiness Scale in Obstructive Sleep Apnea

The Predictive Value of Epworth Sleepiness Scale in Obstructive Sleep Apnea

Risk factors of sleep-disordered breathing in haemodialysis patients

Sonolência diurna excessiva e qualidade de vida relacionada à saúde dos professores universitários

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