Correlation between self-reported and questioned Epworth sleepiness scale results including polysomographic outcomes

Abstract

Abstract Introduction Obstructive sleep apnea (OSA) is characterized by a recurrent complete or partial obstruction in the upper airways accompanied by desaturation attacks and recurrent awakenings (arousal) during sleep and is associated with excessive sleepiness and poor quality of life. Excessive daytime sleepiness (EDS) has long been recognized as the most important symptom of OSA and Epworth sleepiness scale (ESS) is a simple, easy-to-understand, self-reported, validated scale used in the evaluation of patients with obstructive sleep apnea syndrome (OSAS). Objective Some researchers have reported that ESS has controversial results in evaluating OSAS due to the fact that it is based on self-reporting. It is known that ESS is a self-administered patient questionnaire, but it can also be administered by the doctor, and the information about the latter’s validity, reliability, and correlation with OSAS is limited. This study was conducted to compare the outcomes of ESS self-administered by the patient and administered by a doctor in patients with OSAS. Methods Ninety-three patients with OSAS symptoms, with polysomnography test results, and who were presented in a tertiary hospital in 2019 for snoring and apnea problems were included in this study. ESS, consisting of eight questions and used to measure daytime sleepiness in various situations on the basis of self-reporting, was used. Subsequently, ESS was repeated, but this time verbally administered by the doctor to the patient. ESS is a 4-point Likert-type scale scored with 0, 1, 2, and 3. Excessive daytime sleepiness is accepted in individuals with a total score of 11 or more. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) program. Results Of the patients who participated in this study, 57% (n = 53) were male and 43% (n = 40) were female. The average age of the patients was 48.1±9.71. The body mass index (BMI) average was 29.7±5.66 kg/m2, and the average neck circumference was 38.6±4.62 cm. The mean value of the completed ESS self-administered by the patient (ESSp) was calculated as 11.0±5.25 and that of the ESS administered by the doctor (ESSd) was 7.9±4.76. For the results, while daytime sleepiness was 35.5% in ESSd, it was 52.7% in ESSp. A positive correlation was found between the ESSd and ESSp values and BMI. A positive correlation was also found between the apnea-hypopnea index (AHI) and BMI. Conclusions The ESS administered by a doctor will yield more accurate data about the severity of OSAS than the ESS self-administered by the patient.

Keywords

• Obstructive sleep apnea
• Epworth sleepiness scale
• Polysomnography
• Apnea