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European Archives of Oto-Rhino-Laryngology

, Volume 269, Issue 4, pp 1143–1147 | Cite as

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

  • Seung Ju Lee
  • Hyun Woo Kang
  • Lae Hyung Lee
Rhinology

Abstract

The aim of this study was to investigate the relationship between the subjective Epworth Sleepiness Scale (ESS) and objective polysomnographic parameters that was compared in dichotomized groups of obstructive sleep apnea (OSA) patients with and without excessive daytime sleepiness (EDS). A retrospective review of the 96 consecutive snoring patients suspected of OSA due to upper airway problems was performed. ESS score was assessed and EDS was considered present when the ESS score was >10. Polysomnography was performed for each patient. Comparisons of polysomnographic parameters between both groups of patients were performed using Mann–Whitney U-tests. The Pearson’s correlation coefficient was calculated. EDS patients showed significantly greater body mass index (BMI), AHI and ODI, higher percentage of snoring time, a longer time length of SpO2 < 90% and lower minimum SpO2 compared to no EDS patients. There was no statistical difference in other sleep parameters. A positive correlation between the ESS score and BMI, percentage of snoring time, minimum SpO2 and time length of SpO2 < 90% was identified. Despite many controversies, our conclusion is that apnea/hypoxemia has considerable coherence to account for the EDS measured by ESS in OSA patients.

Keywords

Epworth sleepiness scale Excessive daytime sleepiness Obstructive sleep apnea Polysomnography 

References

  1. 1.
    Seneviratne U, Puvanendran K (2004) Excessive daytime sleepiness in obstructive sleep apnea: prevalence, severity, and predictors. Sleep Med 5:339–343PubMedCrossRefGoogle Scholar
  2. 2.
    Mediano O, Barceló A, De la Peña M, Gozal D, Agustí A, Barbé F (2007) Daytime sleepiness and polysomnographic variables in sleep apnoea patients. Eur Respir J 30:110–113PubMedCrossRefGoogle Scholar
  3. 3.
    Briones B, Adams N, Strauss M, Rosenberg C, Whalen C, Carskadon M, Roebuck T, Winters M, Redline S (1996) Relationship between sleepiness and general health status. Sleep 19:583–588PubMedGoogle Scholar
  4. 4.
    Cho YW, Lee JH, Son HK, Lee SH, Shin C, Johns MW (2011) The reliability and validity of the Korean version of the Epworth sleepiness scale. Sleep Breath 15:377–384Google Scholar
  5. 5.
    Hayashida K, Inoue Y, Chiba S, Yagi T, Urashima M, Honda Y, Itoh H (2007) Factors influencing subjective sleepiness in patients with obstructive sleep apnea syndrome. Psychiatry Clin Neurosci 61:558–563PubMedCrossRefGoogle Scholar
  6. 6.
    Chen R, Xiong KP, Lian YX, Huang JY, Zhao MY, Li JX, Liu CF (2011) Daytime sleepiness and its determining factors in Chinese obstructive sleep apnea patients. Sleep Breath 15:129–135PubMedCrossRefGoogle Scholar
  7. 7.
    Bausmer U, Gouveris H, Selivanova O, Goepel B, Mann W (2010) Correlation of the Epworth Sleepiness Scale with respiratory sleep parameters in patients with sleep-related breathing disorders and upper airway pathology. Eur Arch Otorhinolaryngol 267:1645–1648PubMedCrossRefGoogle Scholar
  8. 8.
    Iber C, Ancoli-Israel S, Chesson AL, Quan SF (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, 1st edn. American Academy of Sleep Medicine, WestchesterGoogle Scholar
  9. 9.
    DA AS (1992) EEG arousals: scoring rules and examples: a preliminary report from the sleep disorders atlas task force of the American sleep disorders association. Sleep 15:173–184Google Scholar
  10. 10.
    Sun Y, Ning Y, Huang L, Lei F, Li Z, Zhou G, Tang X (2011) Polysomnographic characteristics of daytime sleepiness in obstructive sleep apnea syndrome. Sleep Breath (Epub ahead of print)Google Scholar
  11. 11.
    Roure N, Gomez S, Mediano O, Duran J, Peña Mde L, Capote F, Teran J, Masa JF, Alonso ML, Corral J, Sánchez-Armengod A, Martinez C, Barceló A, Gozal D, Marín JM, Barbé F (2008) Daytime sleepiness and polysomnography in obstructive sleep apnea patients. Sleep Med 9:727–731PubMedCrossRefGoogle Scholar
  12. 12.
    Kapur VK, Baldwin CM, Resnick HE, Gottlieb DJ, Nieto FJ (2005) Sleepiness in patients with moderate to severe sleep-disordered breathing. Sleep 28:472–477PubMedGoogle Scholar
  13. 13.
    Jiménez-Correa U, Haro R, González-Robles RO, Velázquez-Moctezuma J (2011) How is the Epworth Sleepiness Scale related with subjective sleep quality and polysomnographic features in patients with sleep-disordered breathing? Sleep Breath 15:513–518Google Scholar
  14. 14.
    Goncalves MA, Paiva T, Ramos E, Guilleminault C (2004) Obstructive sleep apnea syndrome, sleepiness, and quality of life. Chest 125:2091–2096PubMedCrossRefGoogle Scholar
  15. 15.
    Veasey SC, Davis CW, Fenik P, Zhan G, Hsu YJ, Pratico D, Gow A (2004) Long-term intermittent hypoxia in mice: protracted hypersomnolence with oxidative injury to sleep-wake brain regions. Sleep 15:194–201Google Scholar
  16. 16.
    Gottlieb DJ, Yao Q, Redline S, Ali T, Mahowald MW (2000) Does snoring predict sleepiness independently of apnea and hypopnea frequency? Am J Respir Crit Care Med 162:1512–1517PubMedGoogle Scholar
  17. 17.
    Lim LL, Tham KW, Fook-Chong SM (2008) Obstructive sleep apnoea in Singapore: polysomnography data from a tertiary sleep disorders unit. Ann Acad Med Singapore 37:629–636PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology, Head and Neck Surgery, Eulji HospitalEulji University College of MedicineSeoulSouth Korea

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