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, SPO2, ODI and Arousal Index, the Spearman’s correlation coefficient was calculated. No correlation between ESS and AHI, minimal SpO2 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 SpO2 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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Young T, Blustein J, Finn L, Palta M (1997) Sleep-disordered breathing and motor vehicle accidents in a population-based sample of employed adults. Sleep 20:608–613
Becker HF (2007) Schlafbezogene Atmungsstörungen. In: Peter H, Penzel T, Peter JH (eds) Enzyklopädie der Schlafmedizin. Springer Medizin Verlag, Heidelberg, pp 1054–1064 (in German)
Guilleminault C, Tilkian A, Dement WC (1976) The sleep apnea syndromes. Ann Rev Med 27:465–484
American Thoracic Society (1989) Medical Section of the American Lung Association Indications and standards for cardiopulmonary sleep studies. Am Rev Respir Dis 139:559–568
American Academy of Sleep Medicine Task Force (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep 22:667–689
Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14:540–545
Johns MW (1993) Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale. Chest 103:30–36
Gottlieb DJ, Whitney CW, Bonekat WH, Iber C, James GD, Lebowitz M et al (1999) Relation of sleepiness to respiratory disturbance index: the Sleep Heart Health Study. Am J Respir Crit Care Med 159:502–507
Hayashida K, Inoue Y, Chiba S, Yagi T, Urashima M, Honda Y et al (2007) Factors influencing subjective sleepiness in patients with obstructive sleep apnea syndrome. Psychiatry Clin Neurosci 61:558–563
Chervin RD, Aldrich MS, Pickett R, Guilleminault C (1997) Comparison of the results of the Epworth Sleepiness Scale and the multiple sleep latency test. J Psychosom Res 42:145–155
Olson LG, Cole MF, Ambrogetti A (1998) Correlations among Epworth Sleepiness Scale scores and multiple sleep latency test scores and psychological symptoms. J Sleep Res 7:248–253
Furuta H, Kaneda R, Kosaka K, Arai H, Sano J, Koshino Y (1999) Epworth Sleepiness Scale and sleep studies in patients with obstructive sleep apnea syndrome. Psychiatry Clin Neurosci 53:301–302
Guilleminault C, Do Kim Y, Chowdhuri S, Horita M, Ohayon M, Kushida C (2001) Sleep and daytime sleepiness in upper airway resistance syndrome compared to obstructive sleep apnoea syndrome. Eur Respir J 17:838–847
Kapur VK, Baldwin CM, Resnick HE, Gottlieb DJ, Nieto FJ (2005) Sleepiness in patients with moderate to severe sleep-disordered breathing. Sleep 28:472–477
American Academy of Sleep Medicine (2005) ICSD-2—The International Classification of Sleep Disorders, 2nd edn. American Academy of Sleep Medicine, Westchester
Roure N, Gomez S, Mediano O, Duran J, Peña Mde L, Capote F et al (2008) Daytime sleepiness and polysomnography in obstructive sleep apnea patients. Sleep Med 9:727–731
Stepanski E, Lamphere J, Badia P, Zorick F, Roth T (1984) Sleep fragmentation and daytime sleepiness. Sleep 7:18–26
Roehrs T, Zorick F, Wittig R, Conway W, Roth T (1989) Predictors of objective level of daytime sleepiness in patients with sleep-related breathing disorders. Chest 95:1202–1206
Acknowledgments
The authors acknowledge the contribution of Dr. Röhrig (IMBEI, Institute for Medical Biometry, Epidemiology and Informatics, University of Mainz, Germany) in the form of statistical consultation and statistical processing of the data.
Conflict of interest statement
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bausmer, U., Gouveris, H., Selivanova, O. et al. 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, 1645–1648 (2010). https://doi.org/10.1007/s00405-010-1250-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-010-1250-y