Clinical Reproducibility of the Epworth Sleepiness Scale

Nguyen, Anh Tu Duy; Baltzan, Marc; Small, David; Wolkove, Norman; Guillon, Simone; Palayew, Mark

doi:10.5664/jcsm.26512

Cited by 100 publications

(74 citation statements)

References 18 publications

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“…GPs were likely to have given patients weight loss advice after the GP score; however, it is unlikely significant weight would be lost in the mean 90-day period between GP referral and oximetry assessment sufficient to change the ESS scores. This assumption was confirmed in the Nguyen study where fewer than 2% of subjects lost 10 pounds or more after initial assessment (Nguyen et al, 2006). GPs could have suggested other conservative advice, such as extending sleep times, or treated other causes of elevated ESS, such as depression; it is uncertain how much effect this could have had on scores, and as scores between GP and other settings did not tend to change in one direction, i.e.…”

Section: Resultsmentioning

confidence: 85%

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The reliability of the Epworth Sleepiness Score in a sleep clinic population

Taylor

Zeng

O'Dochartaigh

2018

Journal of Sleep Research

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Despite the Epworth Sleepiness Score being widely used, there are limited studies of its reliability in clinical practice. The aim of this study was to assess the reliability of the Epworth Sleepiness Score in a clinical population. The study included patients referred to Middlemore Hospital sleep service between October and November 2014, aged over 17 years, with at least two Epworth Sleepiness Score measurements at up to three different points on the diagnostic pathway: on General Practitioner referral (GP Epworth Sleepiness Score); at overnight oximetry assessment (Oximetry Epworth Sleepiness Score); and at a specialist clinic (Specialist Epworth Sleepiness Score). No treatment was administered between scores. One-hundred and thirty-three patients were included in the study. There was a median of 91 days from GP Epworth Sleepiness Score to Oximetry Epworth Sleepiness Score, and 11 days from Oximetry Epworth Sleepiness Score to Specialist Epworth Sleepiness Score. There was poor test-retest reliability between GP Epworth Sleepiness Score and Specialist Epworth Sleepiness Score; 72.4% and 17.8% of patients had an absolute difference of more than 2 and 8 Epworth Sleepiness Score points, respectively. A Bland-Altman plot of mean Epworth Sleepiness Score versus the difference between GP Epworth Sleepiness Score and Specialist Epworth Sleepiness Score demonstrated a wide scatter of data and 95% confidence interval for the difference in Epworth Sleepiness Score for an individual patient of -14 to +10. There was similar variability between GP Epworth Sleepiness Score and Oximetry Epworth Sleepiness Score. The reliability of the Epworth Sleepiness Score is unproven in clinical settings. This study shows poor test-retest reliability of Epworth Sleepiness Score, particularly between primary and secondary care, arguing against the use of Epworth Sleepiness Score for clinical decision-making or prioritisation of services without first assessing the reliability of the Epworth Sleepiness Score in the relevant clinical population.

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Section: Resultsmentioning

confidence: 85%

“…cient (ICC) implied good repeatability at 0.86. In terms of evaluations of ESS reliability in clinical populations, Nguyen et al (2006) evaluated ESS in 142 patients referred to a private snoring clinic and then on for a sleep study. The mean length of time between scores was 71 days.…”

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confidence: 99%

The reliability of the Epworth Sleepiness Score in a sleep clinic population

Taylor

Zeng

O'Dochartaigh

2018

Journal of Sleep Research

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“…Test–retest reliability was reported to be high based on testing separated in time by 5 months in healthy subjects (r = 0.82, P < 0.001) (31). In subjects with OSA, with testing separated by an average of 71 days, r = 0.73 ( P < 0.001) (33).…”

Section: Epworth Sleepiness Scale (Ess)mentioning

confidence: 99%

Measures of sleep in rheumatologic diseases: Epworth Sleepiness Scale (ESS), Functional Outcome of Sleep Questionnaire (FOSQ), Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI)

Omachi¹

2011

Arthritis Care & Research

103

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“…16 The Epworth Sleepiness Scale (ESS) was used to assess the severity of subjective daytime sleepiness. 17 Body composition was measured by bioelectrical impedance analysis (BIA 101 Body Impedance Analyser; Akern, Florence, Italy). Echocardiographic examinations (M-mode, two-dimensional and Doppler) were performed using a Vivid 7 (GE Healthcare, Wauwatosa, WI, USA) equipped with a 2.5 MHz transducer.…”

Section: Measurementsmentioning

confidence: 99%

Differential patterns of regional neuroadrenergic cardiovascular drive in acromegalic disease

Seravalle

Carzaniga

Sciortino

et al. 2013

Clin Exp Pharma Physio

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It has been shown that acromegaly is characterized by an autonomic imbalance and by marked sympathoinhibition. However, there is no information available as to whether adrenergic inhibition is confined to selected vascular districts or, rather, is generalized. We examined 17 newly diagnosed active acromegalic patients without hyperprolactinaemia, pituitary hormone deficiencies, obstructive sleep apnoea and cardiac hypertrophy and 14 healthy subjects matched for age, sex and body mass index. For each subject, we collected information regarding anthropometric parameters and echocardiography, and collected plasma samples to investigate anterior pituitary function, glucose and lipid metabolism and plasma leptin levels. Beat-to-beat mean arterial pressure, heart rate and efferent post-ganglionic muscle and skin sympathetic nerve traffic (MSNA and SSNA, respectively; determined by microneurography) were measured. Both MSNA and SSNA were recorded in a randomized sequence over two 30 min periods. Measurements also included evaluation of SSNA responses to emotional stimulus. In addition to significant reductions in plasma leptin levels, acromegalic patients had markedly decreased MSNA compared with the healthy controls. There were no significant differences in SSNA between the two groups, either under basal conditions or in responses to arousal stimuli. There was a significant and direct correlation between MSNA and plasma leptin levels, but not between plasma leptin and SSNA. These data provide the first evidence that the sympathetic inhibition characterizing the early phase of acromegaly is not generalized to the entire cardiovascular system.

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Clinical Reproducibility of the Epworth Sleepiness Scale

Cited by 100 publications

References 18 publications

The reliability of the Epworth Sleepiness Score in a sleep clinic population

The reliability of the Epworth Sleepiness Score in a sleep clinic population

Measures of sleep in rheumatologic diseases: Epworth Sleepiness Scale (ESS), Functional Outcome of Sleep Questionnaire (FOSQ), Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI)

Differential patterns of regional neuroadrenergic cardiovascular drive in acromegalic disease

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