Correlation of the Epworth sleepiness scale and sleep-disordered breathing in men and women

Melissa Lipford, Dietlind L. Wahner-Roedler, Gail A. Welsh, Jayawant Mandrekar, Prabin Thapa, Eric J. Olson

Research output: Contribution to journalArticle

Abstract

Study Objectives: To compare Epworth Sleepiness Scale (ESS) scores of men and women and determine if there is a correlation with sleep-disordered breathing (SDB) based on subsequent polysomnography (PSG). Methods: Consecutive adult patients were identified who completed ESS and PSG at Mayo Clinic in Rochester, Minnesota, between January 1, 2013, and January 31, 2015. Apnea-hypopnea index (AHI) ≥ 5 events/h was classified as presence of SDB, and increasing values represented greater severity. Results: Among 6,593 patients with valid ESS scores and timely subsequent PSG, 42% were women. Mean (standard deviation [SD]) age of women was 56.2 (15.2) years; men, 58.5 (15.1) years. Mean (SD) ESS score was 9.5 (5.4) for women and 9.5 (5.3) for men. SDB was present in 83.6% of men and 68.3% of women. Mean (SD) AHI of men was 25.9 (26.7) events/h; women, 16.1 (22.4) events/h (P < .001). Each unit increase in ESS score of men was associated with a 0.51-unit increase in AHI (P < .001); women had a 0.16-unit associated increase (P = .04) (effect ratio, threefold greater for men). PSG demonstrated that women had greater sleep efficiency, less respiratory effort-related arousals, and less hypoxemia (all P < .001). Among women, ESS did not correlate with presence of SDB or mild to moderate SDB. There was a small association in women with severe SDB. Conclusions: ESS is not correlated with SDB at mild to moderate levels in women and has a smaller association than in men with severe SDB. Further work is necessary to understand sex-specific differences in patients with SDB.

Original languageEnglish (US)
Pages (from-to)33-38
Number of pages6
JournalJournal of Clinical Sleep Medicine
Volume15
Issue number1
DOIs
StatePublished - Jan 15 2019

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Sleep Apnea Syndromes
Polysomnography
Apnea
Arousal
Sex Characteristics
Sleep

Keywords

  • Obstructive sleep apnea
  • OSA in women
  • Sleepiness in OSA by sex

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

Cite this

Correlation of the Epworth sleepiness scale and sleep-disordered breathing in men and women. / Lipford, Melissa; Wahner-Roedler, Dietlind L.; Welsh, Gail A.; Mandrekar, Jayawant; Thapa, Prabin; Olson, Eric J.

In: Journal of Clinical Sleep Medicine, Vol. 15, No. 1, 15.01.2019, p. 33-38.

Research output: Contribution to journalArticle

Lipford, Melissa ; Wahner-Roedler, Dietlind L. ; Welsh, Gail A. ; Mandrekar, Jayawant ; Thapa, Prabin ; Olson, Eric J. / Correlation of the Epworth sleepiness scale and sleep-disordered breathing in men and women. In: Journal of Clinical Sleep Medicine. 2019 ; Vol. 15, No. 1. pp. 33-38.
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abstract = "Study Objectives: To compare Epworth Sleepiness Scale (ESS) scores of men and women and determine if there is a correlation with sleep-disordered breathing (SDB) based on subsequent polysomnography (PSG). Methods: Consecutive adult patients were identified who completed ESS and PSG at Mayo Clinic in Rochester, Minnesota, between January 1, 2013, and January 31, 2015. Apnea-hypopnea index (AHI) ≥ 5 events/h was classified as presence of SDB, and increasing values represented greater severity. Results: Among 6,593 patients with valid ESS scores and timely subsequent PSG, 42{\%} were women. Mean (standard deviation [SD]) age of women was 56.2 (15.2) years; men, 58.5 (15.1) years. Mean (SD) ESS score was 9.5 (5.4) for women and 9.5 (5.3) for men. SDB was present in 83.6{\%} of men and 68.3{\%} of women. Mean (SD) AHI of men was 25.9 (26.7) events/h; women, 16.1 (22.4) events/h (P < .001). Each unit increase in ESS score of men was associated with a 0.51-unit increase in AHI (P < .001); women had a 0.16-unit associated increase (P = .04) (effect ratio, threefold greater for men). PSG demonstrated that women had greater sleep efficiency, less respiratory effort-related arousals, and less hypoxemia (all P < .001). Among women, ESS did not correlate with presence of SDB or mild to moderate SDB. There was a small association in women with severe SDB. Conclusions: ESS is not correlated with SDB at mild to moderate levels in women and has a smaller association than in men with severe SDB. Further work is necessary to understand sex-specific differences in patients with SDB.",
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KW - Obstructive sleep apnea

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