The language of sleepiness in obstructive sleep apnea beyond the Epworth,Sleep and Breathing

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The language of sleepiness in obstructive sleep apnea beyond the Epworth
Sleep and Breathing ( IF 2.1 ) Pub Date : 2022-09-13 , DOI: 10.1007/s11325-022-02703-1
Bernie Y Sunwoo ₁ , Christopher N Kaufmann ₂ , Andrea Murez ₃ , Ellen Lee ₄ , Dillon Gilbertson ₁ , Naa-Oye Bosompra ₁ , Pamela DeYoung ₁ , Atul Malhotra ₁

Affiliation

Purpose

Obstructive sleep apnea (OSA) is underdiagnosed, partially from variable clinical presentations. Emphasis is often placed on Epworth Sleepiness Scale (ESS), a subjective measure of sleepiness, but variable in OSA. We hypothesized that daytime complaints measured with Language of Sleepiness Questionnaire (LOS) in OSA are not being captured by ESS.

Methods

Adults referred to a tertiary sleep clinic undergoing sleep studies completed ESS and LOS questionnaires (20 items with various patient-reported descriptors). LOS was examined in patients who had or did not have OSA without sleepiness based on ESS < 10. Cluster analysis was performed to assess whether or not groups of individuals differed based on classification with or without OSA and with or without ESS-based sleepiness.

Results

Approximately half the study population (n = 185 completed) had OSA. ESS score (mean ± SD) was 9.0 ± 5.4. There was no significant difference in ESS between patients with and without OSA (9.0 ± 5.1 vs 9.1 ± 5.7, p = 0.969). In patients with OSA, females, older patients and white patients were significantly less likely to have an ESS ≥ 10 when compared to patients with an ESS < 10. In patients with an ESS < 10, there were no significant differences in descriptors of sleepiness between patients with and without OSA with the most common descriptors selected being “I lack energy,” “I wake up sleepy,” “I keep waking up,” and “I don’t sleep enough.”

Conclusions

The ESS failed to discriminate patients with OSA from those without OSA. Despite an ESS < 10, both daytime and sleep complaints using the LOS questionnaire were present in patients with OSA. Asymptomatic OSA may be less common than previously reported.

中文翻译：

Epworth 之外的阻塞性睡眠呼吸暂停中的困倦语言

目的

阻塞性睡眠呼吸暂停 (OSA) 的诊断不足，部分原因在于不同的临床表现。通常重点关注 Epworth 嗜睡量表 (ESS)，这是一种主观的嗜睡量度，但在 OSA 中存在变化。我们假设 ESS 没有捕获 OSA 中用嗜睡语言问卷 (LOS) 测量的白天投诉。

方法

转诊至三级睡眠诊所接受睡眠研究的成年人完成了 ESS 和 LOS 问卷（20 个项目，包含各种患者报告的描述符）。根据 ESS < 10，对患有或不患有 OSA 但不嗜睡的患者进行 LOS 检查。进行聚类分析以评估个体组是否根据有或没有 OSA 以及有或没有基于 ESS 嗜睡的分类而存在差异。

结果

大约一半的研究人群（完成人数= 185）患有 OSA。 ESS 评分（平均值±标准差）为 9.0±5.4。患有和不患有 OSA 的患者之间 ESS 没有显着差异（9.0 ± 5.1 vs 9.1 ± 5.7， p = 0.969）。在 OSA 患者中，与 ESS < 10 的患者相比，女性、老年患者和白人患者 ESS ≥ 10 的可能性显着降低。在 ESS < 10 的患者中，患有和不患有 OSA 的患者最常见的描述是“我缺乏精力”、“我醒来时很困”、“我一直醒”和“我睡眠不足”。