-Objective: To determine the correlations between excessive daytime sleepiness (EDS), assessed by the Epworth sleepiness scale (ESS), and the multiple sleep latency test (MSLT) and nocturnal sleep architecture features, clinical symptoms of narcolepsy (CSN) and subjective sleep quality (SSQ) in patients with narcolepsy. Method: Twenty three untreated patients were studied and compared with a matched control group. Diagnosis of narcolepsy was carried out employing a clinical interview, a polysomnographic (PSG) record, and an MSLT. Results: Subjective number of awakenings was the SSQ indicator that best correlated with EDS (ESS and MSLT). Regarding clinical features, diurnal tiredness and sleep paralysis correlated with ESS values. Increase in ESS was related with decrease in total sleep time, SWS, and sleep onset latency. On the other hand, increase in MSLT was related with decrease in SWS. Conclusion: These data suggest that EDS in patients with narcolepsy could be impaired by disturbed nocturnal sleep.KEy WORDS: narcolepsy, clinical symptoms, subjective sleep quality, sleep architecture, Epworth sleepiness scale, multiple sleep latency test, excessive daytime sleepiness. Correlação entre as características objetivas e subjetivas do sono noturno e a hipersonolência diurna em pacientes narcolepticosResumo -Objetivo: Determinar as correlações entre hipersonolência, avaliada pela escala de sonolência Epworth (ESE) e o teste múltiplo de latência do sono (TMLS) com a arquitetura do sono (AS), sintomas e qualidade subjetiva do sono em pacientes narcolepticos. Método: Comparou-se um grupo de vinte e tres pacientes narcolepticos sem tratamento com grupo controle. O diagnóstico de narcolepsia foi realizado por uma entrevista clinica, polissonografia e o TMLS. Resultados: O número subjetivo de despertares foi o indicador com maior relação com a hipersonolência, o cansaço diurno e a paralisia do sono também foi correlacionados com a ESE.O aumento do índice na ESE foi correlacionado com uma diminuição do tempo total do sono, no sono de ondas lentas (SOL) e com a latência para o início do sono. O incremento na TMLS foi relacionado com diminuição do SOL. Conclusão: Os dados sugerem que a hipersonolência diurna em pacientes portadores de narcolepsia pode se correlacionar com as alterações da arquitetura do sono noturno. PALAVRAS-CHAVE: sintoma clínico de narcolepsia, qualidade subjetiva do sono, teste múltiplo de latência do sono, hipersonolência.

Unexpectedly, DS severity was related with increases in TST and REM sleep. As has been described in SDB patients, a change in muscular tonus throughout sleep onset (and depth) is a causal factor of SDB features and DS impairment. Therefore, we propose that increases in TST and REM are worsening factors of SDB and consequently, also in DS.

The Epworth Sleepiness Scale (ESS) has been reputed as a quick, valid, and reliable method to assess Daytime sleepiness (DS). Since its publication, it has been translated into a number of languages. Our aim was to determine validity and reliability indicators of an Spanish language version ESS for Mexican population. Considering that in developing countries the majority of persons use public transportation, validity and reliability indicators were also assessed utilizing the ESS without item 8. ESS was applied to a Group of college students (GCS), a selected group of Healthy subjects (HS), and a Group of patients with Sleep disorders (GPSD). We made an ESS comparison among the 3 groups, calculated the correlation between the ESS and the Multiple Sleep Latency Test (MSLT) and determined construct validity and internal consistency. GCS and GHS had lower ESS scores than GPSD. Regarding convergence validity, we obtained a negative correlation between the ESS and the MSLT; we also found a rise in the ESS score associated with an increase in the Apnea-hypopnea index (AHI). With respect to construct validity (employing main component analysis and varimax rotation), we found that one factor explains 52.01% of variance. We determined that the ESS internal consistency was 0.85. When item eight was suppressed, validity and reliability remained acceptable. The present ESS Spanish-language exhibited suitable levels of validity and reliability. Use of the ESS, suppressing item eight, allows assessment of DS more accurately in individuals who do not travel by automobile on a regular basis.