Naslov
The Epworth sleepiness scale 23 years after: Is daytime sleepiness still a valid screening tool for sleep apnea

Autori
Puretic, Hrvoje ; Plavec, Davor ; Pavlisa, Gordana ; Zuljevic, ervin ; Samarzija, Miroslav ; Jakopovic, Marko

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
22nd Annual Congress, Munich, Germany

Mjesto i datum
Minhen, Njemačka, 01.09.2014

Vrsta sudjelovanja
Poster

Vrsta recenzije
Recenziran

Ključne riječi
daytime sleepiness ; sleep apnea ; screening tool

Sažetak
OBJECTIVE Sleep apnea (SA) is a common medical problem burdened by numerous comorbidities and economical costs. Since the introduction of the Epworth Sleepiness Scale (ESS) as a screening tool, daytime sleepiness was considered the most common and prominent symptom of SA. Aim of this study was to reevaluate diagnostic validity of ESS compared to the results of polysomnography (PSG) being a gold standard for SA diagnosis. METHODS Total of 266 patients (mean age 57.9±11.6 yrs ; 189 men and 77 women), referred to our sleep lab because of probable SA, were given ESS followed by an overnight PSG study. The ESS values were compared to PSG apnea hypopnea index (AHI) with sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (DA) calculated for ESS. The positive cut-off value for ESS was ≥10 and for AHI ≥5. RESULTS Ninety two subjects (34.6%) had positive ESS. SA was diagnosed by PSG in 213 (80.1%) subjects: 46 (17.3%) having mild, 37 (13.9%) moderate and 130 (48.9%) severe apnea. Most subjects with positive ESS (88.0%) were found to have positive PSG, but unexpectedly, most subjects with negative ESS (75.9%) were also PSG positive (42% of them with AHI ≥30). Area under ROC curve for ESS was 0.59 (95% CI, 0.52-0.68) with SE of ESS being 38.0%, SP 79.3%, PPV 88.0%, NPV 24.1% and DA 46.2%. CONCLUSION We found that daytime sleepiness measured by ESS is not a valuable screening tool for detecting SA patients, especially when the test is negative. Other screening tests that do not rely solely on daytime sleepiness but on other parameters should be considered (e.g. Berlin questionnaire, Stop bang).

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti

POVEZANOST RADA