Repeating administration of Epworth Sleepiness Scale is clinically useful
Purpose We aimed to verify whether it is clinically useful to repeat the Epworth Sleepiness Scale (ESS) in individuals with suspected sleep-disordered breathing (SDB). Methods In this cross-sectional, prospective study, results of the repeated administration of the ESS were analyzed. In 929 consecut...
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Published in | Sleep & breathing Vol. 15; no. 4; pp. 763 - 773 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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Berlin/Heidelberg
Springer-Verlag
01.12.2011
Springer Springer Nature B.V |
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Abstract | Purpose
We aimed to verify whether it is clinically useful to repeat the Epworth Sleepiness Scale (ESS) in individuals with suspected sleep-disordered breathing (SDB).
Methods
In this cross-sectional, prospective study, results of the repeated administration of the ESS were analyzed. In 929 consecutive patients, ESS was obtained as usual in the laboratory routine, immediately before the sleep study (ESS1) and was repeated in the morning, after the polysomnography (ESS2). ROC curve, classical psychometry, and item response theory (IRT) Rasch analysis were used to assess measurement properties of ESS.
Results
The ESS1 score was (mean ± SD), 11 ± 5.1, and the ESS2, 13 ± 4.7 (
p
< 0.001). Change in ESS score is explained in multivariate analysis by age, but not by gender, educational level, change in Stanford Sleepiness Scale, symptoms of sleep disorder, or polysomnography results. Accuracy of an ESS score >10 to predict apnea–hypopnea index ≥5 increased from 56% (ESS1) to 72% (ESS2). IRT psychometric properties (unidimensionality, invariance, local independence) were maintained in ESS2.
Conclusions
Repeating the administration of the Epworth Sleepiness Scale in a clinical setting increases its score and diagnostic accuracy and correlation with SDB variables, without changing the psychometric properties of the scale. This experiment indicates the clinical usefulness of repeating the ESS. The scale can be repeated at a negligible cost, before dismissing individual patients on the basis of a low ESS score, discontinuing a potentially lifesaving diagnostic and therapeutic process. |
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AbstractList | We aimed to verify whether it is clinically useful to repeat the Epworth Sleepiness Scale (ESS) in individuals with suspected sleep-disordered breathing (SDB). In this cross-sectional, prospective study, results of the repeated administration of the ESS were analyzed. In 929 consecutive patients, ESS was obtained as usual in the laboratory routine, immediately before the sleep study (ESS1) and was repeated in the morning, after the polysomnography (ESS2). ROC curve, classical psychometry, and item response theory (IRT) Rasch analysis were used to assess measurement properties of ESS. The ESS1 score was (mean ± SD), 11±5.1, and the ESS2, 13±4.7 (p<0.001). Change in ESS score is explained in multivariate analysis by age, but not by gender, educational level, change in Stanford Sleepiness Scale, symptoms of sleep disorder, or polysomnography results. Accuracy of an ESS score >10 to predict apnea-hypopnea index ≥5 increased from 56% (ESS1) to 72% (ESS2). IRT psychometric properties (unidimensionality, invariance, local independence) were maintained in ESS2. Repeating the administration of the Epworth Sleepiness Scale in a clinical setting increases its score and diagnostic accuracy and correlation with SDB variables, without changing the psychometric properties of the scale. This experiment indicates the clinical usefulness of repeating the ESS. The scale can be repeated at a negligible cost, before dismissing individual patients on the basis of a low ESS score, discontinuing a potentially lifesaving diagnostic and therapeutic process.[PUBLICATION ABSTRACT] PURPOSEWe aimed to verify whether it is clinically useful to repeat the Epworth Sleepiness Scale (ESS) in individuals with suspected sleep-disordered breathing (SDB). METHODSIn this cross-sectional, prospective study, results of the repeated administration of the ESS were analyzed. In 929 consecutive patients, ESS was obtained as usual in the laboratory routine, immediately before the sleep study (ESS1) and was repeated in the morning, after the polysomnography (ESS2). ROC curve, classical psychometry, and item response theory (IRT) Rasch analysis were used to assess measurement properties of ESS. RESULTSThe ESS1 score was (mean ± SD), 11 ± 5.1, and the ESS2, 13 ± 4.7 (p < 0.001). Change in ESS score is explained in multivariate analysis by age, but not by gender, educational level, change in Stanford Sleepiness Scale, symptoms of sleep disorder, or polysomnography results. Accuracy of an ESS score >10 to predict apnea-hypopnea index ≥5 increased from 56% (ESS1) to 72% (ESS2). IRT psychometric properties (unidimensionality, invariance, local independence) were maintained in ESS2. CONCLUSIONSRepeating the administration of the Epworth Sleepiness Scale in a clinical setting increases its score and diagnostic accuracy and correlation with SDB variables, without changing the psychometric properties of the scale. This experiment indicates the clinical usefulness of repeating the ESS. The scale can be repeated at a negligible cost, before dismissing individual patients on the basis of a low ESS score, discontinuing a potentially lifesaving diagnostic and therapeutic process. Purpose We aimed to verify whether it is clinically useful to repeat the Epworth Sleepiness Scale (ESS) in individuals with suspected sleep-disordered breathing (SDB). Methods In this cross-sectional, prospective study, results of the repeated administration of the ESS were analyzed. In 929 consecutive patients, ESS was obtained as usual in the laboratory routine, immediately before the sleep study (ESS1) and was repeated in the morning, after the polysomnography (ESS2). ROC curve, classical psychometry, and item response theory (IRT) Rasch analysis were used to assess measurement properties of ESS. Results The ESS1 score was (mean ± SD), 11 ± 5.1, and the ESS2, 13 ± 4.7 ( p < 0.001). Change in ESS score is explained in multivariate analysis by age, but not by gender, educational level, change in Stanford Sleepiness Scale, symptoms of sleep disorder, or polysomnography results. Accuracy of an ESS score >10 to predict apnea–hypopnea index ≥5 increased from 56% (ESS1) to 72% (ESS2). IRT psychometric properties (unidimensionality, invariance, local independence) were maintained in ESS2. Conclusions Repeating the administration of the Epworth Sleepiness Scale in a clinical setting increases its score and diagnostic accuracy and correlation with SDB variables, without changing the psychometric properties of the scale. This experiment indicates the clinical usefulness of repeating the ESS. The scale can be repeated at a negligible cost, before dismissing individual patients on the basis of a low ESS score, discontinuing a potentially lifesaving diagnostic and therapeutic process. We aimed to verify whether it is clinically useful to repeat the Epworth Sleepiness Scale (ESS) in individuals with suspected sleep-disordered breathing (SDB). In this cross-sectional, prospective study, results of the repeated administration of the ESS were analyzed. In 929 consecutive patients, ESS was obtained as usual in the laboratory routine, immediately before the sleep study (ESS1) and was repeated in the morning, after the polysomnography (ESS2). ROC curve, classical psychometry, and item response theory (IRT) Rasch analysis were used to assess measurement properties of ESS. The ESS1 score was (mean ± SD), 11 ± 5.1, and the ESS2, 13 ± 4.7 (p < 0.001). Change in ESS score is explained in multivariate analysis by age, but not by gender, educational level, change in Stanford Sleepiness Scale, symptoms of sleep disorder, or polysomnography results. Accuracy of an ESS score >10 to predict apnea-hypopnea index ≥5 increased from 56% (ESS1) to 72% (ESS2). IRT psychometric properties (unidimensionality, invariance, local independence) were maintained in ESS2. Repeating the administration of the Epworth Sleepiness Scale in a clinical setting increases its score and diagnostic accuracy and correlation with SDB variables, without changing the psychometric properties of the scale. This experiment indicates the clinical usefulness of repeating the ESS. The scale can be repeated at a negligible cost, before dismissing individual patients on the basis of a low ESS score, discontinuing a potentially lifesaving diagnostic and therapeutic process. |
Author | Santos Lumertz, Magali Cassol, Cristiane Maria Martinez, Denis Cataldo Breitenbach, Tiago Sfreddo Lenz, Maria do Carmo Sicca da Rocha, Neusa Lerias Alcântara, Denise |
Author_xml | – sequence: 1 givenname: Denis surname: Martinez fullname: Martinez, Denis email: dm@ufrgs.br organization: Division of Cardiology, Hospital de Clinicas de Porto Alegre (HCPA), Sleep Clinic, Universidade Federal do Rio Grande do Sul (UFRGS) – sequence: 2 givenname: Tiago surname: Cataldo Breitenbach fullname: Cataldo Breitenbach, Tiago organization: Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS) – sequence: 3 givenname: Magali surname: Santos Lumertz fullname: Santos Lumertz, Magali organization: Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) – sequence: 4 givenname: Denise surname: Lerias Alcântara fullname: Lerias Alcântara, Denise organization: Sleep Clinic – sequence: 5 givenname: Neusa surname: Sicca da Rocha fullname: Sicca da Rocha, Neusa organization: Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS) – sequence: 6 givenname: Cristiane Maria surname: Cassol fullname: Cassol, Cristiane Maria organization: Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS) – sequence: 7 givenname: Maria do Carmo surname: Sfreddo Lenz fullname: Sfreddo Lenz, Maria do Carmo organization: Sleep Clinic |
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CitedBy_id | crossref_primary_10_1212_WNL_0b013e318297ef18 crossref_primary_10_1183_16000617_0012_2016 crossref_primary_10_1378_chest_12_2174 crossref_primary_10_1007_s11325_014_1078_6 crossref_primary_10_1007_s11325_013_0911_7 crossref_primary_10_1016_j_sleep_2017_10_004 crossref_primary_10_5664_jcsm_8166 crossref_primary_10_5005_jp_journals_10069_0046 crossref_primary_10_3724_SP_J_1042_2018_01213 crossref_primary_10_3342_kjorl_hns_2013_56_8_495 |
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Keywords | Epworth Sleepiness Scale Sleep apnea Hypersomnolence Polysomnography Item response theory Sleep-disordered breathing Nervous system diseases Sleep apnea syndrome Respiratory disease Theory Sleep disorder Sleep Sleep wake cycle Neurological disorder |
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Snippet | Purpose
We aimed to verify whether it is clinically useful to repeat the Epworth Sleepiness Scale (ESS) in individuals with suspected sleep-disordered... We aimed to verify whether it is clinically useful to repeat the Epworth Sleepiness Scale (ESS) in individuals with suspected sleep-disordered breathing (SDB).... PURPOSEWe aimed to verify whether it is clinically useful to repeat the Epworth Sleepiness Scale (ESS) in individuals with suspected sleep-disordered breathing... |
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SubjectTerms | Adult Biological and medical sciences Clinical trials Dentistry Disorders of Excessive Somnolence - diagnosis Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes Female Fundamental and applied biological sciences. Psychology Humans Internal Medicine Investigative techniques of ocular function and vision Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Medicine Medicine & Public Health Middle Aged Nervous system (semeiology, syndromes) Neurology Original Article Otorhinolaryngology Pediatrics Pneumology/Respiratory System Polysomnography Psychometrics - statistics & numerical data Reference Values Reproducibility of Results Sleep Apnea, Obstructive - diagnosis Sleep disorders Sleep. Vigilance Surveys and Questionnaires Vertebrates: nervous system and sense organs |
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Title | Repeating administration of Epworth Sleepiness Scale is clinically useful |
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