Gender differences in Epworth Sleepiness Scale revealed by paired patient-spouse scoring

Evaluation of daytime sleepiness in the clinical sleep practice is commonly performed by administering the Epworth Sleepiness Scale (ESS). Our study investigates gender differences of ESS responses in patients (PTs) with a primary complaint of nighttime sleep disruption as they relate to ESS responses obtained from PTs' spouses (Ss).

One hundred and sixty-four patient-spouse (PT-S) pairs were recruited for the study and asked to independently complete ESS questionnaires consisting of 8 sleepiness scenarios (Q1-Q8). Descriptive summaries were frequencies and percentages for categorical data, and medians and quartiles for continuous variables. Differences between PT-S pairs and different data sets were evaluated using a two-tail independent T test and Wilcoxon's Rank Sum Test. All analyses were done in SAS for Windows 9.4.

Eighty-five male and 75 female PTs were recruited for the study. Female PTs reported significantly higher total ESS scores than male PTs (12.16 vs 9.64, p < 0.0001) and had significantly higher sleepiness for scenarios Q1, Q4, Q6, and Q8. When compared with their Ss' responses, male PTs underestimated, while female PTs overestimated their sleepiness with statistical significance observed for total ESS score as well as for all sleepiness scenarios except for Q5 ("lying down to rest in the afternoon"). African-American (AA) males reported significantly higher total ESS scores than Caucasian (C) males, while AA females reported lower total ESS scores than C females. Discrepancy between PT-S ESS scores was higher in C than in AA PTs.

Significant gender differences were noted when PT-S ESS responses were compared. Demonstrated gender differences were further influenced by the PT's race.