Epworth Sleepiness Scale Case Study
Evaluation of Epworth Sleepiness Scale as a screening method for Obstructive Sleep Apnea Syndrome (OSAS)
ABSTRACT
Objective: To compare the results of the Epworth Sleepiness Scale (ESS) score and the Apnea-Hypopnea Index (AHI) measured by overnight polysomnography in patients diagnosed to have Obstructive Sleep Apnea Syndrome in King Hussein Medical Center (KHMC), to evaluate the Epworth Sleepiness Scale as a screening method for OSAS.
Method: Retrospective study of patients diagnosed to have obstructive sleep apnea syndrome between 2013 and 2015. Epworth Sleepiness Scale score and Apnea-Hypopnea Index of 118 patients were compared.
Results: Of the 118 patients diagnosed to have Obstructive Sleep Apnea Syndrome, 65 patients had a score …show more content…
However, the PSG is expensive, time consuming and not widely available outside big medical centers. Another problem is the long waiting for PSG. All of these issues urge us to find a simple and reliable way to screen patients for the probability of OSAS before referring them to an overnight polysomnography. Many tests have been evaluated and studied. The Multiple Sleep Latency Test (MSLT) is believed to provide a reliable measurement of sleepiness. (7,8) The Maintenance of Wakefulness Test (MWT) (9) and the Modified Assessment of Sleepiness Test (MAST) (10) were also shown to be reliable when it comes to evaluating patients with sleep disturbances. However, all these tests have the same disadvantage of being cumbersome, expensive and time consuming. The Epworth Sleepiness Scale was developed in 1991, and was suggested as a screening method for patients with suspected OSAS. Despite the fact that it is subjective, ESS has the advantage of being fast, free and easy to be applied. (11) Our aim in this study is to evaluate the Epworth Sleepiness Scale (ESS) as a screening method for …show more content…
From the 47 patients diagnosed to have mild OSAS in our study, 17 patients had an ESS score >10, which means that only 36% of these patients had an ESS score suggestive of EDS. In the group of patients with moderate OSAS which consisted from 43 patients, 20 patients had an ESS score >10, which means that 46.5% of them had an ESS score suggestive of EDS. Overall, 55% of the patients who were diagnosed to have OSAS in this study had an ESS>10, leaving nearly half of the patients (45%) with an ESS score NOT suggestive of EDS. This means that the ESS has a low sensitivity as a screening method for OSAS. This result was also concluded by other studies, such as the meta-analysis done by Ramachandran and Josephs (13), which evaluated several clinical screening tests for OSAS. They concluded that the ESS was the least accurate of all the screening tests examined in the study.
Conclusion The ESS is a very simple, cheap and fast way to assess patients for the possibility of EDS and OSAS. However, it has low accuracy in the mild and moderate OSAS
ABSTRACT
Objective: To compare the results of the Epworth Sleepiness Scale (ESS) score and the Apnea-Hypopnea Index (AHI) measured by overnight polysomnography in patients diagnosed to have Obstructive Sleep Apnea Syndrome in King Hussein Medical Center (KHMC), to evaluate the Epworth Sleepiness Scale as a screening method for OSAS.
Method: Retrospective study of patients diagnosed to have obstructive sleep apnea syndrome between 2013 and 2015. Epworth Sleepiness Scale score and Apnea-Hypopnea Index of 118 patients were compared.
Results: Of the 118 patients diagnosed to have Obstructive Sleep Apnea Syndrome, 65 patients had a score …show more content…
However, the PSG is expensive, time consuming and not widely available outside big medical centers. Another problem is the long waiting for PSG. All of these issues urge us to find a simple and reliable way to screen patients for the probability of OSAS before referring them to an overnight polysomnography. Many tests have been evaluated and studied. The Multiple Sleep Latency Test (MSLT) is believed to provide a reliable measurement of sleepiness. (7,8) The Maintenance of Wakefulness Test (MWT) (9) and the Modified Assessment of Sleepiness Test (MAST) (10) were also shown to be reliable when it comes to evaluating patients with sleep disturbances. However, all these tests have the same disadvantage of being cumbersome, expensive and time consuming. The Epworth Sleepiness Scale was developed in 1991, and was suggested as a screening method for patients with suspected OSAS. Despite the fact that it is subjective, ESS has the advantage of being fast, free and easy to be applied. (11) Our aim in this study is to evaluate the Epworth Sleepiness Scale (ESS) as a screening method for …show more content…
From the 47 patients diagnosed to have mild OSAS in our study, 17 patients had an ESS score >10, which means that only 36% of these patients had an ESS score suggestive of EDS. In the group of patients with moderate OSAS which consisted from 43 patients, 20 patients had an ESS score >10, which means that 46.5% of them had an ESS score suggestive of EDS. Overall, 55% of the patients who were diagnosed to have OSAS in this study had an ESS>10, leaving nearly half of the patients (45%) with an ESS score NOT suggestive of EDS. This means that the ESS has a low sensitivity as a screening method for OSAS. This result was also concluded by other studies, such as the meta-analysis done by Ramachandran and Josephs (13), which evaluated several clinical screening tests for OSAS. They concluded that the ESS was the least accurate of all the screening tests examined in the study.
Conclusion The ESS is a very simple, cheap and fast way to assess patients for the possibility of EDS and OSAS. However, it has low accuracy in the mild and moderate OSAS