Correlation of the Epworth Sleepiness Scale with respiratory sleep parameters in patients with sleep-related breathing disorders and upper airway pathology

Abstract

The aim of the study was to test whether a correlation between the Epworth Sleepiness Scale (ESS) and respiratory sleep parameters recorded by polysomnography (PSG) in patients with sleep-related breathing disorders and upper airway pathology exists. The PSG records of 130 patients (average age 52.6 +/- 10.7 years) with upper airway pathology suspected of having obstructive sleep apnea (OSA) have been retrospectively evaluated. Upper airway pathology included deviation of the nasal septum, inferior nasal turbinate hypertrophy, soft palate webbing, elongated uvula, tonsillar hypertrophy, macroglossia, hypertrophy of the tongue base, unfavorable palate position relative to the tongue base. To test for a possible correlation in this patient population between ESS score and arithmetic values of AHI, SPO(2), ODI and Arousal Index, the Spearman's correlation coefficient was calculated. No correlation between ESS and AHI, minimal SpO(2) and ODI was proven and only a weak positive correlation between Arousal Index and ESS was found in this particular patient population. We concluded that in patients with upper airway pathology, it is not possible to predict solely on the basis of the ESS score the existence of OSA or of other disturbances in Arousal Index, minimal SpO(2) and ODI. Nevertheless, historical data evaluated by questionnaires, such as the ESS provide for additional information combined with the clinical findings to select patients who are candidates for further detailed sleep studies.

The relationship between the Epworth Sleepiness Scale and polysomnographic parameters in obstructive sleep apnea patients

“…Compared to no EDS patients, EDS patients exhibited a greater AHI [1,[10][11][12], though not wholly agreed [2]. Recent study showed no correlation between the ESS and the AHI, ODI, and minimum SpO 2 in patients with upper airway pathology [7]. Our data also showed no correlation between the ESS and the AHI, ODI in OSA patients, but significant difference in AHI and ODI was found between the patients with and without EDS.…”

“…The controversies could be due to the following factors. Firstly, the EDS is determined by multiple physiologic or pathologic conditions [7]. Secondly, EDS in OSA patients measured by ESS, a self-assessment method, is not objective but may depend on the subjective personality of the patients [5].…”

“…However, some other works could not find such evidence. Moreover, only a few reports are found in the literature that studied such correlations in the snoring patients who visited ENT clinic with upper airway problems [7]. It is not possible, of course, at this stage to designate determining polysomnographic parameters of EDS.…”

Schlafapnoescreening kardiovaskulärer Patienten im klinischen Alltag

“…Die ESS wird häufig als Verlaufsparameter für Therapieerfolge eingesetzt. Für das Screening von Patienten mit OSA konnten jedoch keine befriedigenden Ergebnisse erzielt werden[2,25].Weitere einfache Screeningverfahren beinhalten die Messung der nächtlichen Oxymetrie. In einem Kollektiv von Patienten mit hoher Prävalenz an OSA konnte die alleinige Messung der nächtli-chen Oxymetrie das Vorliegen einer relevanten Schlafapnoe mit einer Sensitivität von 98% bei einer Spezifität von 48% erkennen[21].…”

Association of Naso-Oro-Pharyngeal Structures with the Sleep Architecture in Suspected Obstructive Sleep Apnea

“…Similarly other deformities e.g., macroglossia, high tongue base, high arched palate, enlarged tonsils, and adenoids, submental fat, etc. also adds to the risks of obstructive sleep apnea [2,3]. Few studies suggest that craniofacial and nasopharyngeal abnormalities may be related to the severity of obstructive sleep apnea [4,5].…”