The Epworth Sleepiness Scale: Validation of One-Dimensional Factor Structure in a Large Clinical Sample

Lapin, Brittany; Bena, James; Walia, Harneet K.; Moul, Douglas E.

doi:10.5664/jcsm.7258

Cited by 64 publications

(38 citation statements)

References 35 publications

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“…Inclusion criteria for recruitment were severe COPD, defined as Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 3–4 criteria with FEV1/FVC < 0.70, FEV1 < 50%, and hypoxemic respiratory failure, defined as the need for supplemental oxygen at rest or with exertion. Patients with obstructive sleep apnea or obesity hypoventilation syndrome were excluded from the study, and all patients were low risk (<10) based on the Epworth sleepiness scale [ 34 ]. Patients with history of a neuromuscular disorder were also excluded.…”

Section: Methodsmentioning

confidence: 99%

Acute Responses to Oxygen Delivery via High Flow Nasal Cannula in Patients with Severe Chronic Obstructive Pulmonary Disease—HFNC and Severe COPD

Attaway

Faress

Jacono

et al. 2021

JCM

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Differences in oxygen delivery methods to treat hypoxemia have the potential to worsen CO2 retention in chronic obstructive lung disease (COPD). Oxygen administration using high flow nasal cannula (HFNC) has multiple physiological benefits in treating respiratory failure including reductions in PaCO2 in a flow-dependent manner. We hypothesized that patients with COPD would develop worsening hypercapnia if oxygen fraction was increased without increasing flow rate. We evaluated the acute response to HFNC in subjects with severe COPD when flow remained constant and inspired oxygen was increased. In total, 11 subjects with severe COPD (FEV1 < 50%) on supplemental oxygen with baseline normocapnia (PaCO2 < 45 mm Hg; n = 5) and hypercapnia (PaCO2 ≥ 45 mm Hg; n = 6) were studied. Arterial blood gas responses were studied at three timepoints: Baseline, HFNC at a flow rate of 30 L/min at resting oxygen supplementation for 1 h, and FiO2 30% above baseline with the same flow rate for the next hour. The primary endpoint was the change in PaCO2 from baseline. No significant changes in PaCO2 were noted in response to HFNC applied at baseline FiO2 in the normocapnic and hypercapnic group. At HFNC with FiO2 30% above baseline, the normocapnic group did not show a change in PaCO2 (baseline: 38.9 ± 1.8 mm Hg; HFNC at higher FiO2: 38.8 ± 3.1 mm Hg; p = 0.93), but the hypercapnic group demonstrated significant increase in PaCO2 (baseline: 58.2 ± 9.3 mm Hg; HFNC at higher FiO2: 63.3 ± 10.9 mm Hg; p = 0.025). We observed worsening hypercapnia in severe COPD patients and baseline hypercapnia who received increased oxygen fraction when flow remained constant. These data show the need for careful titration of oxygen therapy in COPD patients, particularly those with baseline hypercapnia when flow rate is unchanged.

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Section: Methodsmentioning

confidence: 99%

Acute Responses to Oxygen Delivery via High Flow Nasal Cannula in Patients with Severe Chronic Obstructive Pulmonary Disease—HFNC and Severe COPD

Attaway

Faress

Jacono

et al. 2021

JCM

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“…Items range from 0 (no chance of dozing) to 3 (high likelihood of dozing), and total scores range from 0–24, with higher values representing increased daytime sleepiness. The ESS is a standard clinical and research tool that is well validated [ 33 ]. The ESS was previously translated into Spanish [ 34 ].…”

Section: Methodsmentioning

confidence: 99%

Acculturation Associated with Sleep Duration, Sleep Quality, and Sleep Disorders at the US–Mexico Border

Ghani

Delgadillo

Granados

et al. 2020

IJERPH

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Sleep disparities exist among Hispanics/Latinos, although little work has characterized individuals at the United States (US)–Mexico border, particularly as it relates to acculturation. This study examined the association of Anglo and Mexican acculturation to various facets of sleep health among those of Mexican descent at the US–Mexico border. Data were collected from N = 100 adults of Mexican descent in the city of Nogales, Arizona (AZ). Surveys were presented in English or Spanish. Acculturation was assessed with the Acculturation Scale for Mexican-Americans (ARSMA-II). Insomnia was assessed with the Insomnia Severity Index (ISI), sleepiness was assessed with the Epworth Sleepiness Scale (ESS), sleep apnea risk was assessed with the Multivariable Apnea Prediction (MAP) index, weekday and weekend sleep duration and efficiency were assessed with the Sleep Timing Questionnaire, sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and sleep duration and sleep medication use were assessed with PSQI items. No associations were found between Mexican acculturation and any sleep outcomes in adjusted analyses. Anglo acculturation was associated with less weekend sleep duration and efficiency, worse insomnia severity and sleep quality, and more sleep apnea risk and sleep medication use. These results support the idea that sleep disparities may depend on the degree of acculturation, which should be considered in risk screening and interventions.

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“…a pictorial version for patients with diminished literacy skills), making it accessible worldwide. In addition, the ESS has high internal consistency in measuring EDS in patients with OSA [11,40]. In general, studies have found the ESS to have good test-retest reliability in controlled clinical trial settings or when administered in similar clinical settings, and less reliability when administered across different primary and secondary care settings (e.g.…”

Section: Self-report Assessments Of Edsmentioning

confidence: 99%

Residual excessive daytime sleepiness in patients treated for obstructive sleep apnea: guidance for assessment, diagnosis, and management

Rosenberg

Schweitzer

Steier

et al. 2021

Postgraduate Medicine

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Excessive daytime sleepiness (EDS) affects approximately half of patients with obstructive sleep apnea (OSA) and can persist in some despite normalization of breathing, oxygenation, and sleep quality with primary OSA therapy, such as continuous positive airway pressure (CPAP). EDS is often overlooked and under discussed in the primary care setting and in the follow-up of CPAP-treated patients due to difficult assessment of such a multi-dimensional symptom. This review aims to provide suggestions for procedures that can be implemented into routine clinical practice to identify, evaluate, and manage EDS in patients treated for OSA, including how to appropriately use various self-report and objective assessments along the clinical pathway and options for pharmacotherapy. In addition, examples of when it is appropriate to refer a patient to a sleep specialist for evaluation are discussed.

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The Epworth Sleepiness Scale: Validation of One-Dimensional Factor Structure in a Large Clinical Sample

Cited by 64 publications

References 35 publications

Acute Responses to Oxygen Delivery via High Flow Nasal Cannula in Patients with Severe Chronic Obstructive Pulmonary Disease—HFNC and Severe COPD

Acute Responses to Oxygen Delivery via High Flow Nasal Cannula in Patients with Severe Chronic Obstructive Pulmonary Disease—HFNC and Severe COPD

Acculturation Associated with Sleep Duration, Sleep Quality, and Sleep Disorders at the US–Mexico Border

Residual excessive daytime sleepiness in patients treated for obstructive sleep apnea: guidance for assessment, diagnosis, and management

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