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Test-Retest Reliability of Epworth Sleepiness Scale Score in Patients with Untreated Obstructive Sleep Apnea
Xujun Feng1,2, Yuan Shi1, Ye Zhang1
1Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
Study Objectives:
This study aimed to evaluate the test-retest reliability of the Epworth Sleepiness Scale (ESS) in patients with untreated obstructive sleep apnea (OSA) and investigate the effects of different follow-up techniques and various factors on ESS score discrepancies.
Methods:
This study prospectively enrolled participants diagnosed with OSA at West China Hospital of Sichuan University from October 2022 to May 2023. Each participant completed a polysomnography (PSG) and the Chinese version of the ESS. Initial ESS evaluations were performed before the PSG and were reassessed either face-to-face or on telephone within a week. Analysis involved Bland-Altman plots, the intraclass correlation coefficient (ICC), and calculation of mean differences.
Results:
We included 382 patients with untreated OSA, averaging 43.52 years old, with a mean body mass index (BMI) of 26.54 kg/m2 and an average apnea-hypopnea index (AHI) of 47.93 events/hour. The ICC was recorded at 0.820. The signed difference in ESS scores from baseline to follow-up was 1.68 ± 2.93 overall. In OSA patients with a BMI > 28, the difference was 2.39 ± 3.46, while in those with an AHI ≥ 30, it was 1.77 ± 3.27.
Conclusion:
This study underscores the significance of repeated ESS testing to improve the reliability of sleepiness evaluations in patients with OSA. Further studies should aim to confirm these findings in a broader demographic and develop refined methods for more precise sleepiness assessments among different OSA groups.
