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Christian Guilleminault - One of the best experts on this subject based on the ideXlab platform.
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diagnostic accuracy of the berlin questionnaire stop bang stop and Epworth Sleepiness Scale in detecting obstructive sleep apnea a bivariate meta analysis
Sleep Medicine Reviews, 2017Co-Authors: Hsiaoyean Chiu, Pin Yuan Chen, Li Pang Chuang, Ning Hung Chen, Yu Jung Hsieh, Yu Chi Wang, Christian GuilleminaultAbstract:Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder; however, it remains underdiagnosed and undertreated. Although screening tools such as the Berlin questionnaire (BQ), STOP-BANG questionnaire (SBQ), STOP questionnaire (STOP), and Epworth Sleepiness Scale (ESS) are widely used for OSA, the findings regarding their diagnostic accuracy are controversial. Therefore, this meta-analysis investigated and compared the summary sensitivity, specificity, and diagnostic odds ratio (DOR) among the BQ, SBQ, STOP, and ESS according to the severity of OSA. Electronic databases, namely the Embase, PubMed, PsycINFO, ProQuest dissertations and theses AI pooled specificity levels were 59%, 42%, 42%, and 65%; and pooled DORs were 4.30, 5.13, 4.85, and 2.18, respectively. For moderate OSA, the pooled sensitivity levels were 77%, 90%, 89%, and 47%; pooled specificity levels were 44%, 36%, 32%, and 621%; and pooled DORs were 2.68, 5.05, 3.71, and 1.45, respectively. For severe OSA, the pooled sensitivity levels were 84%, 93%, 90%, and 58%; pooled specificity levels were 38%, 35%, 28%, and 60%; and pooled DORs were 3.10, 6.51, 3.37, and 2.10, respectively. Therefore, for mild, moderate, and severe OSA, the pooled sensitivity and DOR of the SBQ were significantly higher than those of other screening tools (P < .05); however, the specificity of the SBQ was lower than that of the ESS (P < .05). Moreover, age, sex, body mass index, study sample size, study populations, presence of comorbidities, PSG or portable monitoring performance, and risk of bias in the domains of the index test and reference standard were significant moderators of sensitivity and specificity (P < .05). Compared with the BQ, STOP, and ESS, the SBQ is a more accurate tool for detecting mild, moderate, and severe OSA. Sleep specialists should use the SBQ to conduct patient interviews for the early diagnosis of OSA in clinical settings, particularly in resource-poor countries and sleep clinics where PSG is unavailable.
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diagnostic accuracy of the berlin questionnaire stop bang stop and Epworth Sleepiness Scale in detecting obstructive sleep apnea a bivariate meta analysis
Sleep Medicine Reviews, 2017Co-Authors: Hsiaoyean Chiu, Pin Yuan Chen, Li Pang Chuang, Ning Hung Chen, Yukang Tu, Yu Jung Hsieh, Yu Chi Wang, Christian GuilleminaultAbstract:Summary Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder; however, it remains underdiagnosed and undertreated. Although screening tools such as the Berlin questionnaire (BQ), STOP-BANG questionnaire (SBQ), STOP questionnaire (STOP), and Epworth Sleepiness Scale (ESS) are widely used for OSA, the findings regarding their diagnostic accuracy are controversial. Therefore, this meta-analysis investigated and compared the summary sensitivity, specificity, and diagnostic odds ratio (DOR) among the BQ, SBQ, STOP, and ESS according to the severity of OSA. Electronic databases, namely the Embase, PubMed, PsycINFO, ProQuest dissertations and theses AI pooled specificity levels were 59%, 42%, 42%, and 65%; and pooled DORs were 4.30, 5.13, 4.85, and 2.18, respectively. For moderate OSA, the pooled sensitivity levels were 77%, 90%, 89%, and 47%; pooled specificity levels were 44%, 36%, 32%, and 621%; and pooled DORs were 2.68, 5.05, 3.71, and 1.45, respectively. For severe OSA, the pooled sensitivity levels were 84%, 93%, 90%, and 58%; pooled specificity levels were 38%, 35%, 28%, and 60%; and pooled DORs were 3.10, 6.51, 3.37, and 2.10, respectively. Therefore, for mild, moderate, and severe OSA, the pooled sensitivity and DOR of the SBQ were significantly higher than those of other screening tools ( P P P
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the cyclic alternating pattern demonstrates increased sleep instability and correlates with fatigue and Sleepiness in adults with upper airway resistance syndrome
Sleep, 2007Co-Authors: Christian Guilleminault, Cecilia M Lopes, Chad C Hagen, Agostinho Da RosaAbstract:OBJECTIVE: To clarify the relationship between sleep instability and subjective complaints in patients with upper airway resistance syndrome (UARS). METHODS: Thirty subjects (15 women) with UARS and 30 age- and sex-matched controls in a prospective, single-blind, case-control study. Blinded cyclic alternating pattern (CAP) electroencephalogram analysis and Scales of fatigue and Sleepiness were completed. ANALYSIS: Mann-Whitney U tests for independent, nonparametric variables between groups and chi2 tests for nonparametric variables with defined standard values. RESULTS: Patients with UARS had significantly more complaints of fatigue and Sleepiness, compared with controls, demonstrated on their Fatigue Severity Scale (P < 0.001) and Epworth Sleepiness Scale (P < 0.001). By design, the mean apnea-hypopnea index was normal in both groups, whereas the respiratory disturbance index was greater in patients with UARS than in those without (14.5 +/- 3.0 vs 9 +/- 5.2, respectively [P < 0.001]). CAP analysis demonstrated abnormal non-rapid eye movement sleep with abnormally increased CAP rate, electroencephalogram arousals, A2 index, and A3 index. Decreased A1 index in controls was consistent with their more normal progression of sleep. CAP rate correlated with both the Epworth Sleepiness Scale (r = 0.38, P < 0.01) and the Fatigue Severity Scale (r = 0.51, P < 0.0001), and there was a positive trend between the Fatigue Severity Scale and phase A2 index (r = 0.29, P < 0.05). CONCLUSION: Compared with age- and sex-matched controls, patients with UARS have higher electroencephalogram arousal indexes and important non-rapid eye movement sleep disturbances that correlate with subjective symptoms of Sleepiness and fatigue. These disturbances are identifiable with sensitive measures such as CAP analysis but not with traditional diagnostic scoring systems.
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prolonged confusion with nocturnal wandering arising from nrem and rem sleep a case report
Sleep, 1995Co-Authors: Clete A Kushida, Alex Clerk, Carl M Kirsch, John R Hotson, Christian GuilleminaultAbstract:A 51-year-old man with Machado-Joseph disease had a 3-year history of prolonged confusion following nightly nocturnal wandering. Polysomnography with videotape monitoring revealed 19- to 120-minute sleepwalking episodes emerging from non-rapid eye movement (NREM) sleep and occasionally from rapid eye movement (REM) sleep, followed by 22-47 minutes of prolonged confusion and disorientation. The patient also had a periodic limb movement disorder and obstructive sleep apnea syndrome. Excessive daytime Sleepiness was evident by results from the Epworth Sleepiness Scale and Multiple Sleep Latency Test. A sleep-deprived electroencephalogram (EEG) and a polysomnogram with an expanded EEG montage before and during these episodes revealed no epileptiform activity. A contrast-enhanced brain magnetic resonance imaging (MRI) scan demonstrated findings consistent only with Machado-Joseph disease. The patient improved with a combination of temazepam and carbidopa-levodopa.
Jed Black - One of the best experts on this subject based on the ideXlab platform.
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identifying clinically important difference on the Epworth Sleepiness Scale results from a narcolepsy clinical trial of jzp 110
Sleep Medicine, 2017Co-Authors: Lawrence Scrima, Helene A Emsellem, Philip M Becker, Chad Ruoff, Alan Lankford, Gary Bream, Moise A Khayrallah, Jed BlackAbstract:Abstract Background While scores ≤10 on the Epworth Sleepiness Scale (ESS) are within the normal range, the reduction in elevated ESS score that is clinically meaningful in patients with narcolepsy has not been established. Methods This post hoc analysis of a clinical trial of patients with narcolepsy evaluated correlations between Patient Global Impression of Change (PGI-C) and ESS. Data of adult patients with narcolepsy from a double-blind, 12-week placebo-controlled study of JZP-110, a wake-promoting agent, were used in this analysis. Descriptive statistics and receiver operating characteristic (ROC) analysis compared PGI-C (anchor measure) to percent change from baseline in ESS to establish the responder criterion from patients taking either placebo or JZP-110 (treatments). Results At week 12, patients ( n = 10) who reported being “very much improved” on the PGI-C had a mean 76.7% reduction in ESS score, and patients ( n = 33) who reported being “much improved” on the PGI-C had a mean 49.1% reduction in ESS score. ROC analysis showed that patients who improved were almost exclusively from JZP-110 treatment group, with an area-under-the-curve of 0.9, and revealed that a 25% reduction in ESS (sensitivity, 81.4%; specificity, 80.9%) may be an appropriate threshold for defining a meaningful patient response to JZP-110 and placebo. Conclusions A ≥25% reduction in patients' subjective ESS score may be useful as a threshold to identify patients with narcolepsy who respond to JZP-110 treatment.
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correlation between the Epworth Sleepiness Scale and the maintenance of wakefulness test in patients with narcolepsy participating in two clinical trials of sodium oxybate
Sleep Medicine, 2017Co-Authors: Milton K Erman, Jed Black, Helene A Emsellem, Fannie Mori, Geert MayerAbstract:Abstract Background In evaluating pathologic Sleepiness, the Epworth Sleepiness Scale (ESS) assesses subjective sleep propensity; the Maintenance of Wakefulness Test (MWT) is an objective measure of the ability to stay awake. This analysis evaluated the strength of the correlation between ESS and MWT with regard to absolute values in scores. Methods Data were analyzed separately from the intent-to-treat populations of two eight-week clinical trials of sodium oxybate for the treatment of narcolepsy, SXB-15 and SXB-22. For all treatment groups, correlations between ESS and MWT were evaluated at baseline, week four, and week eight using the Pearson product-moment correlation coefficient. Results Overall, correlations across all treatment groups in each study described an inverse relationship, reflecting the scoring of each measure (ie, whereas higher ESS scores indicate greater Sleepiness, higher MWT scores indicate a greater ability to remain awake). Significant correlations of low-to-moderate strength were observed at all time points in both studies. In SXB-15, correlation coefficients were −0.272, −0.365, and −0.343 at baseline (n = 221), week four (n = 212), and week eight (n = 205), respectively, with all P P Conclusion Although all correlations showed statistical significance, they were of low-to-moderate strength. These results indicate that ESS and MWT measure features of pathologic Sleepiness that may be distinct, but partially overlapping. These data corroborate those of other studies, suggesting that physiologic mechanisms that regulate alertness and sleep propensity may function somewhat independently.
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modafinil for treatment of residual excessive Sleepiness in nasal continuous positive airway pressure treated obstructive sleep apnea hypopnea syndrome
Sleep, 2005Co-Authors: Jed Black, Max HirshkowitzAbstract:STUDY OBJECTIVES: Nasal continuous positive airway pressure (nCPAP) usually reduces Sleepiness in patients with obstructive sleep apnea/hypopnea syndrome. However, even with regular use of nCPAP, some patients experience residual excessive Sleepiness. We evaluated the efficacy and safety of the wake-promoting agent modafinil for treating residual excessive Sleepiness in nCPAP-treated patients. DESIGN: 12-week, multicenter, randomized, double-blind, parallel-group, placebo-controlled trial. PATIENTS: Patients aged 18 to 70 years diagnosed with obstructive sleep apnea/hypopnea syndrome and having residual excessive Sleepiness during nCPAP therapy were eligible. INTERVENTIONS: Once-daily modafinil, 200 mg or 400 mg, or placebo. MEASUREMENTS AND RESULTS: Assessments included the Maintenance of Wakefulness Test, Epworth Sleepiness Scale, Clinical Global Impression of Change, and Functional Outcomes of Sleep Questionnaire. Both doses of modafinil significantly improved mean (SD) sleep latency on the Maintenance of Wakefulness Test at weeks 4, 8, and 12 compared with placebo (week 12: modafinil 400 mg, 15.0 [5.3] minutes; 200 mg, 14.8 [5.3] minutes; placebo, 12.6 [5.8] minutes; P < .0001). The Epworth Sleepiness Scale score decreased more in patients taking modafinil compared with those in the placebo group (week 12: modafinil 400 mg, -4.5 [4.3]; 200 mg, -4.5 [4.7]; placebo, -1.8 [3.5]; P < .0001). At week 12, overall clinical condition improved for 61% and 68% of patients treated with modafinil 200 mg and 400 mg, respectively, versus 37% of placebo-treated patients (P < .001). Modafinil was generally well tolerated and did not adversely affect nighttime sleep or nCPAP use. CONCLUSIONS: These results confirm previous shorter-term controlled trials, indicating modafinil is a useful adjunct therapy for improving wakefulness in patients with residual excessive Sleepiness associated with obstructive sleep apnea/hypopnea syndrome who were treated with nCPAP.
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a pilot study on the effects of sodium oxybate on sleep architecture and daytime alertness in narcolepsy
Sleep, 2004Co-Authors: Mortimer Mamelak, Jed Black, Jacques Montplaisir, Ruzica RistanovicAbstract:Study objectives To measure the effect of nocturnal sodium oxybate administration on sleep architecture in patients with narcolepsy. Design Open-label study. Setting Four accredited sleep clinics. Participants 25 adult patients with narcolepsy-cataplexy. Interventions Patients were weaned from previously used anticataplectic medications and administered increasing nightly doses of sodium oxybate over a 10-week period: 4.5 g for 4 weeks, 6 g for 2 weeks, 7.5 g for 2 weeks, and 9 g for 2 weeks. The effect of sodium oxybate was measured using nocturnal polysomnograms, the Epworth Sleepiness Scale, the Maintenance of Wakefulness Test, and a narcolepsy symptoms questionnaire. Results The nightly administration of sodium oxybate produced dose-related increases in slow-wave sleep and delta power, rapid eye movement sleep increased initially and then decreased in a dose-related manner, nocturnal awakenings decreased, and daytime sleep latency increased. Significant improvements in daytime symptoms were measured by the Maintenance of Wakefulness Test, the Epworth Sleepiness Scale, and the narcolepsy symptom questionnaire. Conclusions Nocturnal administration of sodium oxybate in patients with narcolepsy produces significant improvements in sleep architecture, which coincide with significant improvements in daytime functioning.
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modafinil as adjunct therapy for daytime Sleepiness in obstructive sleep apnea
American Journal of Respiratory and Critical Care Medicine, 2001Co-Authors: Allan I. Pack, Jed Black, Jonathan R L Schwartz, Jean K MathesonAbstract:Patients with obstructive sleep apnea/hypopnea syndrome can experience residual daytime Sleepiness despite regular use of nasal continuous positive airway pressure therapy. This randomized, double-blind, placebo-controlled, parallel group study assessed the efficacy and safety of modafinil for the treatment of residual daytime Sleepiness in such patients. Patients received modafinil (n = 77) (200 mg/d, Week 1; 400 mg/d, Weeks 2 to 4) or matching placebo (n = 80) once daily for 4 wk. Modafinil significantly improved daytime Sleepiness, with significantly greater mean changes from baseline in Epworth Sleepiness Scale scores at Weeks 1 and 4 (p 10 min; 29% versus 25%). Headache (modafinil, 23%; placebo, 11%; p = 0.044) and nervousness (modafinil, 12%; p...
Bizu Gelaye - One of the best experts on this subject based on the ideXlab platform.
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morningness eveningness chronotype poor sleep quality and daytime Sleepiness in relation to common mental disorders among peruvian college students
Psychology Health & Medicine, 2015Co-Authors: Deborah Rose, Bizu Gelaye, Sixto E Sanchez, Benjamin Castaneda, Elena Sanchez, David N Yanez, Michelle A WilliamsAbstract:The study was designed to investigate the association between sleep disturbances and common mental disorders (CMDs) among Peruvian college students. A total of 2538 undergraduate students completed a self-administered questionnaire to gather information about sleep characteristics, sociodemographic, and lifestyle data. Evening chronotype, sleep quality, and daytime Sleepiness were assessed using the Horne and Ostberg morningness–eveningness questionnaire, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale, respectivelty. Presence of CMDs was evaluated using the General Health Questionnaire. Logistic regression procedures were used to examine the associations of sleep disturbances with CMDs while accounting for possible confounding factors. Overall, 32.9% of the participants had prevalent CMDs (39.3% among females and 24.4% among males). In multivariable-adjusted logistic models, those with evening chronotype (odds ratios (OR) = 1.43; 95% CI 1.00–2.05), poor sleep quality (OR = 4.50; 95% CI 3.69–...
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construct validity and factor structure of the pittsburgh sleep quality index and Epworth Sleepiness Scale in a multi national study of african south east asian and south american college students
PLOS ONE, 2014Co-Authors: Bizu Gelaye, Vitool Lohsoonthorn, Somrat Lertmeharit, Wipawan C Pensuksan, Sixto E Sanchez, Seblewengel Lemma, Yemane Berhane, Xiaotong Zhu, Juan Carlos Q Velez, Clarita BarbosaAbstract:Background The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) are questionnaires used to assess sleep quality and excessive daytime Sleepiness in clinical and population-based studies. The present study aimed to evaluate the construct validity and factor structure of the PSQI and ESS questionnaires among young adults in four countries (Chile, Ethiopia, Peru and Thailand).
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eveningness chronotype daytime Sleepiness caffeine consumption and use of other stimulants among peruvian university students
Journal of caffeine research, 2014Co-Authors: Anjalene Whittier, Bizu Gelaye, Sixto E Sanchez, Benjamin Castaneda, Elena Sanchez, David Yanez, Michelle A WilliamsAbstract:Objectives: The aims of this study were to evaluate patterns of circadian preferences and daytime Sleepiness, and to examine the extent to which the consumption of stimulant beverages is associated with daytime Sleepiness and evening chronotype among Peruvian college-age students. Methods: A total of 2,581 undergraduate students completed a self-administered comprehensive questionnaire that gathered information about sleep habits, sociodemographic and lifestyle characteristics, and the use of caffeinated beverages. The Morningness–Eveningness Questionnaire (MEQ) and Epworth Sleepiness Scale (ESS) were used to assess chronotype and daytime Sleepiness. We used multivariable linear and logistic regression procedures to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for the associations of sleep disorders with sociodemographic and behavioral factors. Results: The prevalence of daytime Sleepiness was 35% [95% CI 32.7–36.4] and eveningness chronotype was 10% [95% CI 8.8–11.1%]. Age, sex, cigare...
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Construct Validity and Factor Structure of the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale in a Multi-National Study of African, South East Asian and South American College Students
2014Co-Authors: Bizu Gelaye, Vitool Lohsoonthorn, Somrat Lertmeharit, Wipawan C Pensuksan, Sixto E Sanchez, Seblewengel Lemma, Yemane Berhane, Xiaotong Zhu, Juan Carlos Vélez, Clarita BarbosaAbstract:BackgroundThe Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) are questionnaires used to assess sleep quality and excessive daytime Sleepiness in clinical and population-based studies. The present study aimed to evaluate the construct validity and factor structure of the PSQI and ESS questionnaires among young adults in four countries (Chile, Ethiopia, Peru and Thailand).MethodsA cross-sectional study was conducted among 8,481 undergraduate students. Students were invited to complete a self-administered questionnaire that collected information about lifestyle, demographic, and sleep characteristics. In each country, the construct validity and factorial structures of PSQI and ESS questionnaires were tested through exploratory and confirmatory factor analyses (EFA and CFA).ResultsThe largest component-total correlation coefficient for sleep quality as assessed using PSQI was noted in Chile (r = 0.71) while the smallest component-total correlation coefficient was noted for sleep medication use in Peru (r = 0.28). The largest component-total correlation coefficient for excessive daytime Sleepiness as assessed using ESS was found for item 1 (sitting/reading) in Chile (r = 0.65) while the lowest item-total correlation was observed for item 6 (sitting and talking to someone) in Thailand (r = 0.35). Using both EFA and CFA a two-factor model was found for PSQI questionnaire in Chile, Ethiopia and Thailand while a three-factor model was found for Peru. For the ESS questionnaire, we noted two factors for all four countriesConclusionOverall, we documented cross-cultural comparability of sleep quality and excessive daytime Sleepiness measures using the PSQI and ESS questionnaires among Asian, South American and African young adults. Although both the PSQI and ESS were originally developed as single-factor questionnaires, the results of our EFA and CFA revealed the multi- dimensionality of the Scales suggesting limited usefulness of the global PSQI and ESS scores to assess sleep quality and excessive daytime Sleepiness.
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daytime Sleepiness circadian preference caffeine consumption and khat use among college students in ethiopia
Journal of Sleep Disorders: Treatment and Care, 2014Co-Authors: Darve Robinson, Bizu Gelaye, Seblewengel Lemma, Mahlet G Tadesse, Michelle A Williams, Yemane BerhaneAbstract:Daytime Sleepiness, Circadian Preference, Caffeine Consumption and Khat Use among College Students in Ethiopia Objectives: To estimate the prevalence of daytime Sleepiness and circadian preferences, and to examine the extent to which caffeine consumption and Khat (a herbal stimulant) use are associated with daytime Sleepiness and evening chronotype among Ethiopian college students. Methods: A cross-sectional study was conducted among 2,410 college students. A self-administered questionnaire was used to collect information about sleep, behavioral risk factors such as caffeinated beverages, tobacco, alcohol, and Khat consumption. Daytime Sleepiness and chronotype were assessed using the Epworth Sleepiness Scale (ESS) and the Horne and Ostberg Morningness/Eveningness Questionnaire (MEQ), respectively. Linear and logistic regression models were used to evaluate associations.
Murray W Johns - One of the best experts on this subject based on the ideXlab platform.
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sensitivity and specificity of the multiple sleep latency test mslt the maintenance of wakefulness test and the Epworth Sleepiness Scale failure of the mslt as a gold standard
Journal of Sleep Research, 2000Co-Authors: Murray W JohnsAbstract:Excessive daytime Sleepiness (EDS) is an important symptom that needs to be quantified, but there is confusion over the best way to do this. Three of the most commonly used tests: the multiple sleep latency test (MSLT), the maintenance of wakefulness test (MWT) and the Epworth Sleepiness Scale (ESS) give results that are significantly correlated in a statistical sense, but are not closely related. The purpose of this investigation was to help clarify this problem. Previously published data from several investigations were used to calculate the reference range of normal values for each test, defined by the mean+/-2 SD or by the 2.5 and 97.5 percentiles. The 'rule of thumb' that many people rely on to interpret MSLT results is shown here to be misleading. Previously published results from each test were also available for narcoleptic patients who were drug-free at the time and who by definition had EDS. This enabled the sensitivity and specificity of the three tests to be compared for the first time, in their ability to distinguish the EDS of narcolepsy from the daytime Sleepiness of normal subjects. The receiver operator characteristic curves clearly showed that the ESS is the most discriminating test, the MWT is next best and the MSLT the least discriminating test of daytime Sleepiness. The MSLT can no longer be considered the gold standard for such tests.
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sensitivity and specificity of the multiple sleep latency test mslt the maintenance of wakefulness test and the Epworth Sleepiness Scale failure of the mslt as a gold standard
Journal of Sleep Research, 2000Co-Authors: Murray W JohnsAbstract:SUMMARY Excessive daytime Sleepiness (EDS) is an important symptom that needs to be quantified, but there is confusion over the best way to do this. Three of the most commonly used tests: the multiple sleep latency test (MSLT), the maintenance of wakefulness test (MWT) and the Epworth Sleepiness Scale (ESS) give results that are significantly correlated in a statistical sense, but are not closely related. The purpose of this investigation was to help clarify this problem. Previously published data from several investigations were used to calculate the reference range of normal values for each test, defined by the mean±2 SD or by the 2.5 and 97.5 percentiles. The ‘rule of thumb’ that many people rely on to interpret MSLT results is shown here to be misleading. Previously published results from each test were also available for narcoleptic patients who were drug-free at the time and who by definition had EDS. This enabled the sensitivity and specificity of the three tests to be compared for the first time, in their ability to distinguish the EDS of narcolepsy from the daytime Sleepiness of normal subjects. The receiver operator characteristic curves clearly showed that the ESS is the most discriminating test, the MWT is next best and the MSLT the least discriminating test of daytime Sleepiness. The MSLT can no longer be considered the gold standard for such tests.
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daytime Sleepiness snoring and obstructive sleep apnea the Epworth Sleepiness Scale
Chest, 1993Co-Authors: Murray W JohnsAbstract:The Epworth Sleepiness Scale (ESS) is a simple questionnaire measuring the general level of daytime Sleepiness, called here the average sleep propensity. This is a measure of the probability of falling asleep in a variety of situations. The conceptual basis of the ESS involves a four-process model of sleep and wakefulness. The sleep propensity at any particular time is a function of the ratio of the total sleep drive to the total wake drive with which it competes. ESS scores significantly distinguished patients with primary snoring from those with obstructive sleep apnea syndrome (OSAS), and ESS scores increased with the severity of OSAS. Multiple regression analysis showed that ESS scores were more closely related to the frequency of apneas than to the degree of hypoxemia in OSAS. ESS scores give a useful measure of average sleep propensity, comparable to the results of all-day tests such as the multiple sleep latency test.
Murray W Johns - One of the best experts on this subject based on the ideXlab platform.
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portuguese language version of the Epworth Sleepiness Scale validation for use in brazil
Jornal Brasileiro De Pneumologia, 2009Co-Authors: Alessandra Naimaier Bertolazi, Leonardo Santos Hoff, Vinicius Dallagasperina Pedro, Sergio Saldanha Menna Barreto, Simone Chaves Fagondes, Murray W JohnsAbstract: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 0.05). 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.
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reliability and factor analysis of the Epworth Sleepiness Scale
Sleep, 1992Co-Authors: Murray W JohnsAbstract:The Epworth Sleepiness Scale (ESS) is a self-administered eight-item questionnaire that has been proposed as a simple method for measuring daytime Sleepiness in adults. This investigation was concerned with the reliability and internal consistency of the ESS. When 87 healthy medical students were tested and retested 5 months later, their paired ESS scores did not change significantly and were highly correlated (r = 0.82). By contrast, ESS scores that were initially high in 54 patients suffering from obstructive sleep apnea syndrome returned to more normal levels, as expected, after 3-9 months' treatment with nasal continuous positive airway pressure. The questionnaire had a high level of internal consistency as measured by Cronbach's alpha (0.88). Factor analysis of item scores showed that the ESS had only one factor for 104 medical students and for 150 patients with various sleep disorders. The ESS is a simple and reliable method for measuring persistent daytime Sleepiness in adults.
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a new method for measuring daytime Sleepiness the Epworth Sleepiness Scale
Sleep, 1991Co-Authors: Murray W JohnsAbstract:The development and use of a new Scale, the Epworth Sleepiness Scale (ESS), is described. This is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime Sleepiness. One hundred and eighty adults answered the ESS, including 30 normal men and women as controls and 150 patients with a range of sleep disorders. They rated the chances that they would doze off or fall asleep when in eight different situations commonly encountered in daily life. Total ESS scores significantly distinguished normal subjects from patients in various diagnostic groups including obstructive sleep apnea syndrome, narcolepsy and idiopathic hypersomnia. ESS scores were significantly correlated with sleep latency measured during the multiple sleep latency test and during overnight polysomnography. In patients with obstructive sleep apnea syndrome ESS scores were significantly correlated with the respiratory disturbance index and the minimum SaO2 recorded overnight. ESS scores of patients who simply snored did not differ from controls.