Validity of the epworth sleepiness scale as a screening tool for obstructive sleep apnea

To determine whether the Epworth Sleepiness Scale (ESS) can be improved by having a bed partner or roommate ("partner") also fill out the questionnaire; and to assess the applicability of the eight items in the questionnaire, particularly in an urban population.

Retrospective chart review.

A retrospective chart review was conducted to identify charts of subjects with an ESS score collected from both the subject and a partner. Consensus scores were also identified. Self-reported ESS scores were compared to partner and consensus ESS scores. The number of subjects who did not drive was determined.

One hundred consecutive charts were included in this study. Mean ESS score was significantly higher when scored by the partner (10.4 ± 5.8) compared to the subject (7.2 ± 4.7). In 73% of cases, the subject underestimated their score compared to the score given by the partner. The mean difference in score was 3.2 ± 3.5. Mean consensus ESS score was 12.3 ± 5.4. Using an ESS score of ≥10 as abnormal, subject scores did not correlate with the presence of obstructive sleep apnea (OSA; P = .095). Partner and consensus scores, however, did correlate with the presence of OSA (P = .003 and P =.039, respectively). Thirty-five percent of our subjects did not drive.

The difference in mean ESS score obtained from the subject compared to partner implies that this diagnostic form should be completed as a consensus between the patient and partner to provide a more accurate score.

4 Laryngoscope, 2016 127:525-531, 2017.