Portuguese-language version of the Epworth sleepiness scale: validation for use in Brazil

Abstract

Objective: The aim of this study was to develop a Portuguese-language version of the Epworth sleepiness scale (ESS) for use in Brazil. Methods: The steps involved in creating the ESS in Brazilian Portuguese (ESS-BR) were as follows: translation; back-translation; comparison (by a committee) between the translation and the back-translation; and testing in bilingual individuals. The ESS-BR was applied to a group of patients who were submitted to overnight polysomnography in order to identify obstructive sleep apnea-hypopnea syndrome (OSAHS), insomnia and primary snoring. A control group was composed of subjects with a history of normal sleep habits, without reported snoring. Results: A total of 114 patients and 21 controls were included. The 8-item scores of the ESS-BR had an overall reliability coefficient of 0.83. The study group was composed of 59 patients with OSAHS, 34 patients with primary snoring and 21 patients with insomnia. One-way ANOVA demonstrated significant differences in ESS-BR scores among the four diagnostic groups (p < 0.001). Post-hoc tests between groups showed that the ESS-BR scores of the patients with insomnia did not differ from those of the controls (p > 0.05). The ESS-BR scores were significantly higher for OSAHS patients and for primary snorers than for controls (p < 0.05). In addition, the scores for OSAHS patients were significantly higher than were those for primary snorers (p < 0.05). Conclusions: The results of the present study demonstrate that the ESS-BR is a valid and reliable instrument for the assessment of daytime sleepiness, equivalent to its original version when applied to individuals who speak Brazilian Portuguese.Keywords: Validation studies; Sleep disorders; Cross-cultural comparison; Disorders of excessive somnolence. ResumoObjetivo: Desenvolver uma versão da escala de sonolência de Epworth (ESE) para o português para uso no Brasil. Métodos: A versão no português do Brasil (ESE-BR) foi desenvolvida de acordo com as seguintes etapas: tradução; retrotradução; comparação entre a tradução e a retrotradução (por um comitê); e aplicação em indivíduos bilín-gues. A ESE-BR foi aplicada a um grupo de pacientes submetidos à polissonografia de noite inteira para identificar síndrome da apneia-hipopneia obstrutiva do sono (SAHOS), insônia e ronco primário. Um grupo controle foi composto de indivíduos com história de hábitos normais de sono, sem ronco aparente. Resultados: Um total de 114 pacientes e 21 controles foram incluídos. Os 8 itens do ESE-BR tiveram um coeficiente de confiabilidade total de 0,83. O grupo em estudo foi composto por 59 pacientes com SAHOS, 34 pacientes com ronco primário e 21 pacientes com insônia. One-way ANOVA demonstrou diferenças significativas nos escores do ESE-BR entre os quatro grupos diagnósticos (p < 0,001). Testes post hoc entre grupos pareados mostraram que os escores do ESE-BR para insones não diferiram daqueles dos controles (p > 0,05). Os escores dos pacientes com SAHOS e nos roncadores primários foram significativamente maiores que os...

Impact of obstructive sleep apnea on cognitive performance

“…Screening methods for OSA should be inexpensive. ESS, available in a validated version in Portuguese for use in Brazil is an appropriate use for this purpose and has an excellent cost-benefit profile as well as being easy and quick to administer 17,18 . The limitations related to the subjectivity of the answers provided to questions from the ESS can only be overcome at the moment with the use of objective tests to measure sleepiness, as the multiple sleep latency test, the gold standard for this diagnosis.…”

“…The ESS is a self-administered questionnaire and refers to the possibility of falling asleep in eight different situations of everyday life 17,18 . The likelihood of napping is quantified with a scale ranging from 0 (zero) to 3 (three), where 0 corresponds to none and three, the most likely to doze.…”

“…Scores greater than 10 suggest a high possibility of EDS. Scores over 16 are indicative of severe sleepiness, more commonly found in patients with moderate or severe OSA, narcolepsy, or idiopathic hypersomnia 18 .…”

Effects of an alternating work shift on air traffic controllers and the relationship with excessive daytime sleepiness and stress

“…The impact of EDS on the working adult manifests as decreased productivity, increased absenteeism, higher accident rates and a high probability of disability caused by an EDS-related disease 13 . The National Transportation Safety Board and National Air Traffic Controllers Association have recommended to the Federal Aviation Administration a revision of ATC officers' schedules in order to provide them with rest periods long enough to obtain sufficient restorative sleep 14 .…”

Avaliação dos impactos do trabalho em turnos noturnos na produção de citocinas inflamatórias salivares e na secreção dos hormônios rítmicos melatonina e cortisol

“…Instrumentos para avaliação de fadiga relacionada ao trabalho (YOSHITAKE, 1971), sonolência (BERTOLAZI et al, 2009;PIRES et al, 2007), estresse (REIS; HINO; AÑEZ, 2010) e matutinidade-vespertinidade (BENEDITO-SILVA et al, 1990;HORNE;OSTBERG, 1976) também foram usados para a caracterização da população.…”