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Introduction@#Movement restrictions and changes in medical education around the world due to the Coronavirus 2019 pandemic have been sources of stress, which affect sleep and compound the demands of medical education. In the Philippines, stay-at-home orders were implemented in the National Capital Region on 15 March 2020, and despite various readjustments and re-definitions, remain in effect to date, March 2022. Objectives. This cross-sectional study aims to determine the sleep quality and daytime sleepiness of Filipino medical students during prolonged stay-at-home orders, to compare them with pre-pandemic evaluations, and to explore associations between scores and participant characteristics.@*Methods@#The medical student population of a state-run university in the City of Manila was included, while those on a leave of absence were excluded. The Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index which measure excessive daytime sleepiness and sleep quality, respectively, were disseminated via Google Forms from April to May 2021. @*Results@#Response rate was 87.75% (n=709) with a mean age of 22.9 ± 2.0 years and a 1:1.09 male-to-female ratio. Among the respondents, 41.18% had excessive daytime sleepiness, and was significantly higher for first-year premedicine students. Compared to pre-pandemic scores, daytime sleepiness decreased during the pandemic. On the other hand, 62.34% of the respondents had poor sleep quality, with global scores being significantly higher for the first-year pre-medicine students. Relationships between participants' characteristics and their scores were extremely weak, while a moderately significant correlation existed between global daytime sleepiness and sleep quality scores.@*Conclusion@#Both excessive daytime sleepiness and poor sleep quality remain prevalent during prolonged stay-athome orders. These reflect the effect of the pandemic on stress inherent to medical education, and may be additional facets to be regarded in evaluating the general well-being of medical students.
Subject(s)
SARS-CoV-2ABSTRACT
Introduction: A person spends one third life in sleep, so the quality and quantity of sleep is of utmost importance. Health Care Professionals (HCPs) are more prone to inconsistency in sleep both in quality and quantity, which leads to deflection from health and well-being of themselves and care of others. This study aims to assess the various factors influencing sleep quality and daytime sleepiness among medical and nursing healthcare professionals. Methodology: A cross sectional study was conducted using a structured questionnaire to collect socio-demographic and work-related information, co-morbidity and quality of Sleep using ESS (Epworth Sleepiness Scale) and PSQI (Pittsburgh Sleep Quality Index) scale. Results: Among the 150 HCPs, 64.7% were medical and 35.3% were nursing professionals. 53.6% of medical and 66% of nursing professionals reported poor sleep quality. Increased coffee consumption influences sleep quality and it was found to be statistically significant. Nursing professionals had more excessive daytime sleepiness (58.5%) with significant p-value (p=0.01). Conclusion: According to our study results, sleep quality was poor among nursing professionals which highlights the need for measures to improve their quality of sleep.
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Objective:To compare the value of NoSAS score, STOP-BANG questionnaire (SBQ) and Epworth Sleepiness Scale (ESS) in assessing the risk of obstructive sleep apnea hypopnea syndrome (OSAHS) in patients with respiratory disease (RD).Methods:The clinical data, NoSAS, SBQ and ESS scores of 190 patients who underwent overnight polysomnography (PSG) were collected. According to the receiver operating characteristic (ROC) curve, with different apnea-hypopnea index (AHI) as the judgment cutoff, the sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratio (DOR) and accuracy of the three scales were compared.Results:With AHI ≥5 times/h as the cutoff, the area under the ROC curve (AUC) of NoSAS and SBQ were 0.833 and 0.729, respectively, indicating that both have predictive value for mild OSAHS. Among them, NoSAS had a larger DOR value (16.150), indicating that NoSAS had the higher accuracy in assessing the risk of mild OSAHS. When AHI>15 times/h was used as the cutoff, the AUC value of NoSAS was 0.704, indicating that it has predictive value for moderate OSAHS. When AHI>30 times/h was used as the cutoff, the AUC value (0.706) and DOR value (6.527) of SBQ were high, indicating that it has predictive value and good accuracy for severe OSAHS. The SBQ is more sensitive than NoSAS and ESS when evaluating patients at high risk for OSAHS ( SBQ≥3). Conclusions:When evaluating the risk of mild and moderate OSAHS in RD patients, NoSAS is better than SBQ and ESS, and when evaluating severe OSAHS, SBQ is better than NoSAS and ESS. In clinical work, appropriate predictive tools should be selected according to the actual situation to assess the risk of OSAHS, so as to formulate and implement early intervention plans based on the assessment results.
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Resumen Introducción: La somnolencia diurna excesiva se asocia a distintos desórdenes del sueño y determina un deterioro significativo de la calidad de vida. La escala de somnolencia de Epworth (ESE) es un instrumento frecuentemente utilizado en la práctica clínica para cuantificar somnolencia diurna, pero no ha sido validada en Chile. Objetivo: Validación transcultural y psicométrica de la ESE en Chile (ESE-CL), y evaluación de su sensibilidad y especificidad en el contexto de pacientes con apneas del sueño (SAHOS). Material y Método: Se realizó una adaptación transcultural y validación inicial en un grupo piloto (58 personas), aplicando en dos ocasiones separadas el mismo instrumento (ESE-CL). Se analizó el nivel de confiabilidad con alfa de Cronbach y con test retest. Para evaluar su sensibilidad se aplicó la ESE-CL a 94 pacientes con SAHOS y 100 controles. Resultados: Los valores de confiabilidad alfa de Cronbach y test re-test fue de 0,732 y 0,837, respectivamente. La capacidad de discriminación de SAHOS de la escala de somnolencia de Epworth versión chilena fue de 67%. Conclusión: La ESE-CL es un instrumento válido y confiable. Un puntaje mayor a 11 se asocia a tener mayor riesgo de padecer SAHOS y constituye una herramienta útil y de fácil aplicación clínica ante pacientes con sospecha de SAHOS.
Abstract Introduction: Excessive daytime sleepiness (EDS) is associated with different sleep disorders, which in turn causes a significant decline quality of life. Epworth sleepiness scale (ESS) is a frequently used instrument to quantify EDS, but it has not been validated in Chile. Aim: Transcultural and psychometric validation of ESS Chilean version. Material and Method: ESS-CL was initially adapted and applied to a pilot group on two separate occasions. Reliability was assessed via Cronbach's alpha and test-retest. ESS-CL was applied to 94 patients with diagnosis of obstructive sleep apnea (OSA) and 100 control to assess its sensitivity. Results: Reliability values (Cronbach's alpha and test-retest) were 0.732 y 0.837 respectively. The ability to discriminate OSA was 67%. Conclusion: The ESS-CL is a valid and reliable instrument. A score higher than 11 points is associated with a greater risk of OSA. It is a useful and accessible tool for patients in whom OSA is suspected.
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Obstructive Sleep Apnoea (OSA) is the most common sleep-related breathing disorder and is associated with significant morbidity. A simple but accurate tool to screen patients for OSA is needed. We wanted to compare STOP-BANG Questionnaire & Epworth Sleepiness Scale to predict the probability of OSA. MethodsA prospective observational study of 46 eligible patients was undertaken. They were assessed using SBQ & ESS & stratified as per the risk of OSA. The Apnoea Hypopnea Index (AHI) was calculated & patients were stratified into mild, moderate & severe OSA. The SBQ scores, ESS scores & AHI was then studied along with the predictive probabilities of both questionnaires in diagnosing OSA. ResultsOf the 46 patients, 89.13 % & 45.65 % were classified as high risk on the SBQ & ESS respectively. 78.26 % were diagnosed OSA on the sleep study according to AHI. SBQ had a high sensitivity to predict OSA (97.22 %) & low specificity (40 %). ESS had low sensitivity & high specificity to predict OSA being 52.78 % & 80 % respectively. ConclusionsBoth Stop-Bang questionnaire & ESS help in determining the risk of OSA. STOP-BANG is a better screening parameter due to its high sensitivity & negative predictive value.
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Background: Excessive daytime sleepiness is a key symptom in patients with sleep- breathing disorders (SBD) and represents a new major public health issue due to its repercussions. The ESS is a simple and validated method, which measures the probability of falling asleep in a variety of situations. Aims and objectives is to study the accuracy of the Epworth Sleepiness Scale (ESS) questionnaire in the identification of Obstructive Sleep Apnoea (OSA) in patients with symptoms of sleep disordered breathing in a tertiary care centre.Methods: This present study was conducted in the Department of Respiratory medicine, New Medical College, Kota on 70 adult patients who presented with symptoms of Sleep Disordered Breathing and underwent Type 2 Polysomnography after answering Epworth sleepiness score in Hindi Language.Results: Epworth sleepiness scale has predicted excessive day time sleepiness in 60% of study subjects with ESS score more than 10 taken as cut off. Mean value for ESS in the study was 10.78. 35.71% of the patients had severe OSA diagnosed by polysomnography and 30% patients had moderate OSA. Mild OSA was detected in 7.14% patients. Sensitivity of the ESS score >10 in diagnosing OSA was found to be 72.5%. Specificity of the scale was 73.6%.There was significant correlation between ESS score and diagnosis of OSA (p value <0.001).Conclusions: The study concludes that ESS has got good relevance in predicting OSA in patients with sleep disordered breathing.
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Introduction@#Movement restrictions and changes in medical education around the world due to the Coronavirus 2019 pandemic have been sources of stress, which affect sleep and compound the demands of medical education. In the Philippines, stay-at-home orders were implemented in the National Capital Region on 15 March 2020, and despite various readjustments and re-definitions, remain in effect to date, March 2022. Objectives. This cross-sectional study aims to determine the sleep quality and daytime sleepiness of Filipino medical students during prolonged stay-at-home orders, to compare them with pre-pandemic evaluations, and to explore associations between scores and participant characteristics. @*Methods@#The medical student population of a state-run university in the City of Manila was included, while those on a leave of absence were excluded. The Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index which measure excessive daytime sleepiness and sleep quality, respectively, were disseminated via Google Forms from April to May 2021. @*Results@#Response rate was 87.75% (n=709) with a mean age of 22.9 ± 2.0 years and a 1:1.09 male-to-female ratio. Among the respondents, 41.18% had excessive daytime sleepiness, and was significantly higher for first-year premedicine students. Compared to pre-pandemic scores, daytime sleepiness decreased during the pandemic. On the other hand, 62.34% of the respondents had poor sleep quality, with global scores being significantly higher for the first-year pre-medicine students. Relationships between participants' characteristics and their scores were extremely weak, while a moderately significant correlation existed between global daytime sleepiness and sleep quality scores. @*Conclusion@#Both excessive daytime sleepiness and poor sleep quality remain prevalent during prolonged stay-athome orders. These reflect the effect of the pandemic on stress inherent to medical education, and may be additional facets to be regarded in evaluating the general well-being of medical students.
Subject(s)
SARS-CoV-2ABSTRACT
Introduction: Good quality and adequate amount of sleepis necessary for being healthy. Medical students are proneto more stress due to their academic demands. The sleepamong students is characterized by inadequate sleeping hours,delayed sleep onset, and mid day nap. Current research aimedto study sleep habits among medical students and to findrelationship between sleep habits and stress with academicperformance of students.Material and Methods: This cross–sectional study wascarried out among 139 medical students of third semester,seventh semester and interns enrolled at Maharaja AgrasenMedical College, Agroha (Dist. Hisar), Haryana. Primarytool in this study was a predesigned and semi-structuredquestionnaire. Epworth Sleepiness Scale (ESS) was used toassess daytime sleepiness. Collected data was analysed usingfrequencies, percentages and chi square test.Results: Out of 139 students, 38.8% were considered tohave excessive daytime sleepiness (EDS score >10). Femalestudents (43.1%) were found to have more abnormal EDS scoreas compare to male students(35.1%). Out of total, 70 studentssecured marks between 60-70 percent in which maximumnumber of students (61.42%) were stress free during examsand 54% had sleep duration of 7-10 hours. Good health wasfound to be strongly significant with academic performanceof the students. Duration of study hours was found to besignificant with academic performance of students. Delayedsleep onset was found to be more in female students (55%).Mid day nap was found in 76.25% of students.Conclusion: The negative effects of sleep difficulties havebeen well documented. EDS was more in female students.Also, good health had significant association with academicperformance so the knowledge of importance of good qualityand adequate amount of sleep and its impact on health shouldbe emphasized and translated into practice.
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Objective To investigate the correlation between daytime sleepiness and anxiety,depression in patients with obstructive sleep apnea and hypopnea syndrome(OSAHS).Methods A total of 117 patients with sleep -snoring from September 2015 to September 2017 who admitted to the Department of Respiratory Medicine of Shengjing Hospital Affiliated to China Medical University were collected for general information.ESS,SDS,SAS questionnaire and polysomnography were detected.The differences between simple snoring and OSAHS group were compared,and the correlation between Epworth Sleepiness Scale (ESS),Self-rating Depression Scale (SDS),Self-rating Anxiety Scale(SAS) score was analyzed.Results The scores of ESS,SDS and SAS in the OSAHS group were (16.24 ± 3.82) points,(46.27 ± 9.01) points,(48.21 ± 9.44) points,respectively,which were higher than those in the simple snoring group [(6.0 ± 2.58) points,(35.50 ± 18.40) points,(36.55 ± 17.97) points] (t =-14.425,-2.521,-2.780,all P ＜ 0.05).There was a correlation between SDS or SAS score and ESS score in OSAHS group(r=0.419,0.313,all P ＜0.05).Conclusion The sleepiness and anxiety,depression in OSAHS patients is more severe than simple snoring;ESS score in OSAHS patients can reflect the severity of the disease,the degree of sleepiness in patients with OSAHS is related to depression and anxiety.
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OBJETIVO: el objetivo primario es determinar si los estudiantes de medicina de la Universidad Mayor de San Simón (UMSS) sufren de somnolencia diurna excesiva mediante el uso de la Escala de somnolencia de Epworth (ESE). MÉTODOS: Se trata de un estudio transversal, descriptivo. Estudiantes de medicina de la UMSS completaron una encuesta la cual incluía datos demográficos, escala del sueño de Epworth traducida al español, número de horas nocturnas de sueño, siestas y uso de estimulantes del SNC durante el mes anterior a la realización de la encuesta. RESULTADOS: el universo consistió en 1923 estudiantes y la muestra en 324 estudiantes del primer al quinto curso de carrera de medicina (5% margen de error, 95% nivel de confianza); 57% del sexo femenino, media de edad de 21 años (±2,1), la media de la escala de Epworth fue de 9 (±3,3) (95% IC 8,46-9,54); 23,6% presentó algún grado de somnolencia diurna excesiva; 67% de los estudiantes indican dormir 4-6 hrs diarias; 79% goza entre 5 90 minutos de siesta cada día durante el mes anterior a la encuesta; 76% reporta usar algún tipo de estimulante del sistema nervioso central. CONCLUSIONES: un porcentaje menor pero relevante de estudiantes de medicina de la UMSS tiene algún grado de somnolencia diurna excesiva. Este menor porcentaje puede deberse al uso de siestas; habito comúnmente practicado en nuestro país.
OBJECTIVES: the primary objective is to determine if medical students of San Simon University (UMSS) suffer from excessive daytime sleepiness using the Epworth Sleeping Scale (ESS). METHODS: It was a cross-sectional, descriptive study. Medical students of San Simon University responded to a survey which included demographics, Epworth Sleepiness Scale translated to Spanish, number of nighttime hours of sleep, presence of naps and use of any stimulant of the central nervous system during the month prior to the survey. RESULTS: The universe consisted of 1923 students and the sample was 324 students from the first to the fifth course of the medical school of University of San Simon (5% margin of error, 95% level of confidence); 57% female, mean age was 21 years (±2.1), the average Epworth Sleepiness scale was 9 (±3.3) (95% CI 8.46-9.54); 23.6% presented some degree of excessive daytime sleepiness; 67% of students indicated sleep 4-6 hours daily; 79% enjoy 5 - 90 minute daily naps during the month prior to survey; 76% reported using some type of stimulant of the central nervous system. CONCLUSIONS: A small but relevant number of medical students have some degree of excessive daytime sleepiness. This is maybe due to use of naps; a habit commonly used in our country.
Subject(s)
Humans , Female , Adult , Sleep Deprivation/diagnosis , Sleep Stages , SleepABSTRACT
OBJECTIVE: The Epworth Sleepiness Scale is a measure used for the diagnosis of sleep disorders including obstructive sleep apnea (OSA) syndrome, insomnia, and narcolepsy. Although a Korean version has been developed (the KESS), Korean lifestyle such as the floor culture and low driving rates has not been considered. We aim to develop and validate a modified KESS (mKESS) that reflects the Korean lifestyle. METHODS: The sample consisted of 795 healthy participants and 323 OSA patients. The mKESS was developed by modifying several questions to concern the floor culture (questions 1, 2, 6, and 7) and low driving rates (question 8). Feasibility of the modification was tested by comparing the KESS and mKESS using paired samples t-test and by examining internal consistency reliability. Then, mKESS scores of the OSA patients and general participants were compared to test its validity. RESULTS: Questions 1, 2, 7, and 8 were significantly different when comparing the performances of the general population on both scales. Especially, the mean scores on question 8 were significantly different in the non-driver group, but not in the driver group. Cronbach’s alpha of the mKESS was relatively higher than that of the KESS. Total mKESS scores of the OSA patients were significantly higher than that of the general population. CONCLUSION: The mKESS is more universally applicable for the clinical evaluation of people that live in Korea. Results support that the mKESS can be administered to measure the average daytime sleep propensity of the Korean population as an alternative to the KESS.
Subject(s)
Humans , Diagnosis , Healthy Volunteers , Korea , Life Style , Narcolepsy , Sleep Apnea, Obstructive , Sleep Initiation and Maintenance Disorders , Sleep Wake Disorders , Weights and MeasuresABSTRACT
Introdução: A apneia obstrutiva do sono (AOS) é caracterizada por obstrução das vias aéreas superiores durante o sono e provoca uma série de consequências para o sistema cardiovascular. Estudos mostram associação de apneia obstrutiva do sono com um mau prognóstico em longo prazo após intervenção coronariana e elevação do índice de infarto agudo do miocárdio. Objetivo: Analisar a prevalência de apneia obstrutiva do sono em pacientes no pré-operátorio de cirurgia cardíaca. Métodos: Estudo transversal no qual foi avaliado prevalência de apneia obstrutiva do sono através do Questionário de Berlin e da Escala de Sonolência de Epworth (ESE). Foram incluídos pacientes no período de julho a outubro de 2017, com idade igual ou superior a 18 anos. Resultados: Foram avaliados 40 pacientes, com idade média de 62,35 ± 7,9 anos e a maioria do sexo masculino (72,5%). O procedimento mais prevalente foi à Cirurgia de Revascularização do Miocárdio (CRM) (80%). Foi identificado alto índice de prevalência de AOS em 62,5% dos participantes; 65% dos pacientes não apresentaram índices significativos de sonolência. Conclusão: Com este estudo vimos que pacientes que realizam cirurgia cardíaca, apresentam alta prevalência de AOS, mas não apresentam necessariamente altos índices de sonolência. Percebe-se que entre os pacientes com maior prevalência de AOS existe uma maior prevalência da realização de Cirurgia de Revascularização do Miocárdio (CRM), mostrando a relação direta de doença cardiovascular com AOS.(AU)
Introduction: Obstructive sleep apnea (OSA) is characterized by obstruction of the upper airways during sleep and causes a number of consequences for the cardiovascular system. Studies show an association of obstructive sleep apnea with a poor long-term prognosis after coronary intervention and elevation of the acute myocardial infarction index. Objective: To analyze the prevalence of OSA in patients in the preoperative period of cardiac surgery. Methods: A cross-sectional study evaluating the prevalence of OSA using the Berlin Questionnaire and the Epworth Sleepiness Scale. Patients were included in the period from July to October 2017, aged 18 years or over. Results: A total of 40 patients were evaluated, with a mean age of 62.35 ± 7.9 years and the majority males (72.5%). The most prevalent procedure was coronary artery bypass grafting (80%). A high prevalence rate of OSA was identified in 62.5% of the participants; 65% of the patients did not present significant drowsiness indexes. Conclusion: With this study, we observed that patients who undergo cardiac surgery have a high prevalence of OSA, but do not necessarily present high rates of sleepiness. Among patients with a higher prevalence of OSA, there is a higher prevalence of coronary artery bypass grafting, showing a direct relationship between cardiovascular disease and OSA. (AU)
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Sleep Apnea Syndromes , Cardiovascular Diseases , Intensive Care Units , Thoracic SurgeryABSTRACT
Introdução: A sonolência excessiva diurna (SED) é um importante transtorno do sono e frequentemente é associado à síndrome da apneia-hipopneia obstrutiva do sono (SAHOS). É conhecido como um fator predisponente comum para acidentes, redução da produtividade, comprometimento neurocognitivo e interpessoal e/ou problemas sociais. Portanto, a detecção precoce da SED é fundamental. Objetivo: Avaliar a correlação da escala de sonolência de Epworth (ESE) com parâmetros polissonográficos nos pacientes com SAHOS. Métodos: O estudo avaliou 1264 laudos de exames de polissonografia de pacientes com SAHOS admitidos de janeiro de 2009 até dezembro de 2013 no Instituto do Sono dos Campos Gerais. Os laudos foram divididos inicialmente em grupos de acordo com a gravidade da SAHOS e em seguida de acordo com a pontuação obtida na ESE e avaliados de acordo com os resultados dos parâmetros polissonográficos. Resultados: Dos laudos analisados, 822 (65,03%) eram de pacientes do sexo masculino e 442 (34,97%) do sexo feminino. A análise da pontuação da ESE evidenciou uma relação com a SAHOS (r = 0,175, p < 0,00001). Quando analisado os subgrupos de gravidade, apenas a SAHOS grave apresentou correlação significativa com a ESE (r = 0,136, p = 0,0004). Conclusões: A escala possui correlação com a SAHOS grave. Devido à importância da detecção precoce da sonolência, a ESE pode ser utilizada como método de avaliação rápida em pacientes com a SAHOS, estimando sua gravidade e a existência de SED (AU)
Introduction: Excessive daytime sleepiness (EDS) is an important sleep disorder, frequently associated to the obstructive sleep apnea hypopnea syndrome (OSAHS). It is known to be an important predisposing factor to accidents, decreased productivity, neurocognitive disorders and social issues. Thus, early detection of EDS is crucial. Objective: To evaluate the correlation of the Epworth Sleepiness Scale (ESS) with polysomnographic parameters in patients with OSAHS. Method: The study evaluated 1264 reports of polysomnography of patients with OSAHS admitted from January 2009 to December 2013 at the Instituto do Sono dos Campos Gerais. The reports were initially divided into groups according to the severity of OSAHS and then according to the score obtained in ESE and evaluated according to the results of the polysomnographic parameters. Results: From the analyzed reports, 822 (65.03%) were male patients, and 442 (34.87%) were female patients. According to the ESS scores analysis, a relation was observed between the scale and OSAHS (r = 0.175, p < 0.,00001). However, when divided into subgroups only severe OSAHS presented a significant correlation (r = 0.136, p = 0.0004). Conclusion: The scale is more strongly related with severe OSAHS, which is also more likely to develop EDS. Due to the importance of early detection of sleepiness, the ESS can be used as a method of rapid assessment in patients with OSAHS, to estimate its severity and the presence of SED. (AU)
Subject(s)
Humans , Male , Female , Surveys and Questionnaires , Polysomnography , Sleep Apnea, Obstructive , Disorders of Excessive SomnolenceABSTRACT
Objective To explore the clinical characteristics and prognostic factors in patients with Parkinson's disease (PD) and excessive daytime sleepiness (EDS) and to identify whether EDS could influence the sleep architecture and sleep apnea-related parameters.Methods A total of 130 PD patients were eligible and enrolled in the study.By the Epworth sleepiness scale (ESS),patients were divided into the EDS group (ESS ≥ 10) with 61 patients and the non-EDS group (ESS ＜ 10) with 69 patients.All underwent a video-polysomnography (PSG).Clinical characteristics were mainly evaluated by the unified Parkinson's disease rating scale (UPDRS) and the Hoehn-Yahr(H-Y) stage.while other related scales were applied for evaluating depression,cognitive function,quality of sleep and quality of life.Results A total of 61 patients (46.92％) were diagnosed as EDS (ESS≥ 10).Compared to the non-EDS group,the EDS group had significantly higher score of HAMD,UPDRS Ⅰ and UPDRS Ⅱ,and significantly lower score of MoCA and PDQ (all P ＜ 0.05).Non-conditional logistic regression analysis showed that the scores of HAMD and UPDRS Ⅰ were the main prognostic factors for EDS.Significantly decreased sleep latency (SL) was found in the EDS group by PSG (P =0.008).The score of ESS was showed to be correlated with the scores of HAMD,MoCA,UPDRS Ⅰ,UPDRS Ⅱ,PDQ and SL.Conclusions PD patients with EDS have more severe depression and cognitive dysfunction and worse quality of life.Sleep structure is altered in those patients with decreased sleep latency.Mental status is closely associated with EDS,but not sleep apnea.
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@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To determine whether excessive daytime sleepiness (EDS) as assessed by the Epworth Sleepiness Scale (ESS) is significantly correlated with body mass index (BMI) and Apnea-Hypopnea Index (AHI) in patients suspected of OSAS and whether obesity as assessed by BMI is associated with AHI.<br /><strong>METHODS:</strong><br /><strong>Design:</strong> Non-concurrent cohort study<br /><strong>Setting:</strong> Tertiary Private Hospital<br /><strong>Population:</strong> The charts of 389 patients suspected to have sleep disorders and referred for polysomnography (PSG) at the Center for Snoring and Sleep Disorders in year 2009 were reviewed. Inclusion criteria were patients aged 19 and above with complete data. A total of 238 patient charts were included in the study.<br /><strong>RESULTS:</strong> The study included a total of 238 patient charts. Results showed no significant association between ESS and AHI (p-value >0.05) even when correlated with the different severities of OSAS (p-value>0.05). Sensitivity and specificity of ESS was found to be 54% and 57%, respectively, indicating that ESS is not a sensitive and specific tool to predict the presence of OSAS. These findings suggest that ESS may not be able to significantly identify patients with OSAS. However, BMI showed a significant association with ESS (p-value<0.05) representing more patients with EDS belonging to the obese category. Conversely, obese patients were twice more likely to have EDS, represented by ESS scores of >=10. BMI was also significantly associated with AHI using one-way Anova test.<br /><strong>CONCLUSION:</strong> This report concludes that the ESS alone is insufficient to identify patients with OSAS. Nevertheless, questionnaires like the ESS supplement relevant history to help diagnose patients with sleep disorders particularly OSAS. On the other hand, the ESS showed a significant association with BMI representing more obese patients had excessive daytime sleepiness. The likelihood ratio of having excessive daytime sleepiness is two times more for obese patients. BMI was also significantly associated with AHI which confirms the well established relationship of obesity with OSAS, and shows that obese patients are at higher risk for severe OSAS.</p>
Subject(s)
Humans , Male , Female , Adult , Adolescent , Child , Sleep , Apnea , Body Mass Index , Sleep Apnea, Obstructive , Syndrome , Snoring , Polysomnography , Sleep Wake Disorders , ObesityABSTRACT
OBJECTIVES: Whether daytime sleepiness is proportional to the severity of sleep apnea in obstructive sleep apnea syndrome (OSAS) is controversial. In this study we investigated how insomnia severity affects the association between daytime sleepiness and sleep apnea severity in OSAS. METHODS: The present study included 235 male subjects who were diagnosed with OSAS based on clinical history and nocturnal polysomnography. Pearson's correlation analysis was conducted among sleep and mood-related self-reported data, polysomnographic data and demographic data of all subjects. Based on Pittsburgh Sleep Quality Index (PSQI), the subjects were divided into 2 groups; group A (n = 75; PSQI 5). Partial correlation analysis was performed between the Epworth Sleepiness Scale (ESS) and other data in both groups. Multiple linear regression analysis was conducted to investigate the factors which affected the ESS in group A. RESULTS: Pearson's correlation analysis showed weak or non-existent correlations between ESS and apnea severity data such as apnea-hypopnea index (AHI) (r = 0.148, p = 0.023), apnea index (AI) (r = 0.137, p = 0.036), hypopnea index (HI) (r = 0.058, p = 0.377), oxygen desaturation index (ODI) (r = 0.149, p = 0.022) and arousal total index (ATI) (r = 0.129, p = 0.048). Positive correlations between ESS and apnea severity data such as AHI (r(p) = 0.313, p = 0.008), AI (r(p) = 0.339, p = 0.004), ODI (r(p) = 0.289, p = 0.015) and ATI (r(p) = 0.256, p = 0.031) were observed only in group A. Multiple regression analysis showed that AI (t = 2.996, p = 0.004) and BAI (t = 2.721, p = 0.008) were associated with ESS in group A. CONCLUSION: The correlation between daytime sleepiness and sleep apnea severity was shown only in group A. This result suggests that associations between daytime sleepiness in OSAS and sleep apnea severity will become prominent when controlling for insomnia-related variables.
Subject(s)
Humans , Male , Apnea , Arousal , Linear Models , Oxygen , Polysomnography , Sleep Apnea Syndromes , Sleep Apnea, Obstructive , Sleep Initiation and Maintenance DisordersABSTRACT
OBJECTIVES: To investigate the surgical outcomes of different uvulopalatopharyngoplasty (UPPP). METHODS: All subjects underwent overnight polysomnography and were evaluated using the Epworth sleepiness scale (ESS), the Quebec sleep questionnaire and the snoring scale at the baseline and 3 and 12 months following operation. The primary endpoint was the overall effective rate representing the sum of the surgical success rate and effective rate. RESULTS: The overall effective rate at 12 months post surgery was 55.6% for simple UPPP, 95.8% for UPPP+GA, and 92.3% for UPPP+TBA. The surgical success rate at 3 and 12 months postoperation for UPPP+GA or UPPP+TBA was significantly higher than simple UPPP (P<0.05). Marked improvement was observed in all patients in the snoring scale score and the ESS score 3 and 12 months following surgery compared to the baseline (P<0.05 in all). CONCLUSION: UPPP, UPPP+GA, and UPPP+TBA are all effective in improving the surgical outcome of obstructive sleep apnea hypopnea syndrome (OSAHS) patients with multilevel obstruction. UPPP+TBA appears to be the most effective in treating OSAHS patients.
Subject(s)
Humans , Polysomnography , Prospective Studies , Quebec , Sleep Apnea Syndromes , Sleep Apnea, Obstructive , Snoring , Tongue , Surveys and QuestionnairesABSTRACT
BACKGROUND: Sleep disturbance has become an important health problem for pregnant women. In fact, pregnancy-associated sleep disorder has been recognized as a distinct clinical entity. We aimed to study the relationship between sleep disturbance and preterm birth during pregnancy in a sample of Iranian women. METHODS: In this analytical cohort study, 231 pregnant women in their 28th-32nd gestational week were recruited, using the multistage sampling method, from four healthcare centres in Ardabil, Iran, during 2010. The women were followed-up until 37-week gestation. One hundred and twelve women did not have sleep disturbances while 119 women had sleep disturbances. The Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and a demographic data questionnaire were used for data collection. Data were analysed using SPSS software. Descriptive statistics, t, Chi-square, Fisher's exact, and Mann-Whitney tests were used as appropriate. RESULTS: The prevalence of preterm labour was 11.8%in women with sleep disorder compared with 11.6% in women without sleep disorder (p = 0.9). Sleep duration less than eight hours, daytime dysfunction and impaired quality of life as a component of ISI showed a significant relationship with preterm birth (p = 0.02, p = 0.044, and p = 0.047, respectively). CONCLUSION: Although daily dysfunction and lower quality of life because of sleep problems, and total sleep duration were variables associated with preterm birth, we found no significant relationship between sleep disorder and preterm birth.
ANTECEDENTES: La alteración del sueño se ha convertido en un importante problema de salud para las mujeres embarazadas. De hecho, los trastornos del sueño asociados con el embarazo han sido reconocidos como una entidad clínica distinta. El objetivo del presente trabajo fue estudiar la relación entre los trastornos del sueño y los nacimientos prematuros durante el embarazo en una muestra de mujeres iraníes MÉTODOS: En este estudio de cohorte analítica, se reclutaron 231 mujeres embarazadas en su semana gestacional de 28 - 32, utilizando el método de muestreo por etapas, de cuatro centros de atención a la salud en Ardabil, Irán, durante el año 2010. Las mujeres tuvieron seguimiento hasta la semana 37 de gestación. Ciento doce mujeres no tuvieron trastornos del sueño, en tanto que 119 mujeres tuvieron trastornos del sueño. El índice de severidad de insomnio (ISI), la escala de somnolencia de Epworth (ESS) y un cuestionario de datos demográficos, fueron utilizados para la recolección de datos. Los datos fueron analizados usando el software SPSS. La estadística descriptiva, t, Chi-cuadrado, el test exacto de Fisher, y las pruebas de Mann-Whitney, fueron usadas según correspondiera. RESULTADOS: La prevalencia del trabajo de parto prematuro fue de 11.8% en las mujeres con trastorno del sueño, en comparación con el 11.6% en las mujeres sin trastorno del sueño (p = 0.9). La duración del sueño de menos de ocho horas, la disfunción diurna, así como el deterioro de la calidad de vida como um componente de ISI, mostraron una relación significativa con los nacimientos prematuros (p = 0.02, p = 0.044 y p = 0.047, respectivamente). CONCLUSIÓN: Aunque la disfunción diurna y el deterioro de la calidad de vida debido a problemas con el sueño, al igual que la duración total del sueño, fueron variables asociadas con el parto prematuro, no hallamos ninguna relación significativa entre el trastorno del sueño y los nacimientos prematuros.
Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Sleep Wake Disorders/complications , Obstetric Labor, Premature/etiology , Follow-Up Studies , Statistics, NonparametricABSTRACT
BACKGROUND: Excessive daytime sleepiness is one of the most common symptoms in snoring patients. However, the reason why some individuals complain of daytime sleepiness and others do not is unclear. In this study, we evaluated snoring individuals and examined several demographic and polysomnographic profiles in an attempt to identify predictors of excessive daytime sleepiness. METHODS: The inclusion criteria for patients were the following: 1) patients who underwent an overnight polysomnograph, 2) patients with the chief complaint of snoring, and 3) patients who completed the Korean version of the Epworth sleepiness scale. We used the Epworth sleepiness scale to estimate excessive daytime sleepiness. We quantified correlations between the Epworth sleepiness scale and the demographic/polysomnographic parameters. We also analyzed the parameters affecting excessive daytime sleepiness using multiple linear regression analysis. RESULTS: One hundred nineteen patients met the inclusion criteria for this study. Multiple regression analysis showed that young age was the only independent variable showing statistical significance for predicting excessive daytime sleepiness, and was well-correlated with the Epworth sleepiness scale. However, there were no polysomnographic parameters that were predictive. CONCLUSIONS: Clinicians need to be cautious when using the Epworth sleepiness scale for the diagnosis of obstructive sleep apnea and determining the response to treatment.
Subject(s)
Humans , Diagnosis , Linear Models , Sleep Apnea, Obstructive , SnoringABSTRACT
Objective To evaluate the diagnostic value of Epworth sleepiness scale(ESS) combined with portable sleep monitor (PM) in patients with obstructive sleep apnea syndrome (OSAHS).Methods The questionnaire of ESS was used to evaluate 156 patients with snoring,and then line PM check,monitoring apnea hypoventilation index (AHI),oxygen reduction index (ODI),the lowest oxygen saturation (LSpO2),average blood oxygen saturation (MSpO2).Results One hundred and twenty-four patients were diagnosed to be OSAHS and 32 patients be simple snore by PM in 156 patients.A total of 124 cases,including mild 42 cases,moderate 47 cases,severe 35 cases.There were significant difference in ESS score,AHI,ODI,LSpO2 and MSpO2 between OSAHS in various degrees and patients with simple snore [simple snore:(5.8 ± 2.9) scores,(3.2 ± 1.3) times/h,(3.3 ± 2.6) times,0.911 ± 0.121,0.973 ± 0.132;mild OSAHS:(9.7 ± 3.5) scores,(12.8 ± 23.3) times/h,(14.2 ± 5.7) times,0.875 ± 0.083,0.902 ± 0.095 ; moderate OSAHS:(12.9 ±4.8) scores,(27.6 ± 4.5) times/h,(25.6 ± 6.1) times,0.816 ± 0.069,0.851 ± 0.071 ;severe:(16.1 ± 5.2)scores,(43.6 ± 7.6) times/h,(38.6 ± 7.8) times,0.701 ± 0.061,0.795 ± 0.063] (P ＜ 0.05).With the severity of OSAHS increased,ESS score,AHI,ODI increased gradually,LSpO2,MSpO2 gradually declined,there were statistically significant differences (P ＜ 0.05).ESS score was positively correlated with AHI and ODI (r =0.42,0.51,P ＜ 0.05),and negatively correlated with LSpO2 and MSpO2 (r =-3.70,-4.50,P ＜ 0.05).Conclusions There is a good relativity between ESS score and the monitoring index of PM.Combination of ESS with PM could be used as a primary diagnostic method in patients with OSAHS,especially in primary-care hospitals.