Epworth Sleepiness Scale

About: Epworth Sleepiness Scale is a research topic. Over the lifetime, 4742 publications have been published within this topic receiving 155088 citations.

Reliability and Validity of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in Older Men

Abstract: Sleep complaints and sleep-disordered breathing (SDB) are common in older adults. Over half of elders report some difficulty falling or staying asleep, early waking, requiring a nap, or nonrestorative sleep (1). Estimates of SDB prevalence range as high as 62% in community-dwelling elders (2). The elevated prevalence of sleep disturbance in older adults is particularly troubling in light of studies linking poor sleep to adverse outcomes in this population, including cognitive (3,4) and functional impairment (1). Given the prevalence of sleep disturbance among elders and evidence for adverse consequences of poor sleep, reliable and valid measures are needed to maximize the rigor of late-life sleep assessment. Questionnaires commonly used to quantify sleep disturbance and its consequences include the Pittsburgh Sleep Quality Index (PSQI (5)) for sleep quality and the Epworth Sleepiness Scale (ESS (6)) for daytime sleepiness. The original PSQI validation was performed with mixed-age healthy controls, individuals with major depression, and sleep clinic patients (5). Additional research supports the reliability and validity of the PSQI in various populations, including patients with cancer and other medical conditions (7). The ESS was first shown to be reliable in medical students and patients with a range of sleep disorders (8); its validity was initially demonstrated in patients with sleep disorders and controls (6). We know little, however, about the reliability and validity of the PSQI and ESS in the general population of older adults. We recently studied the internal consistency reliability and construct validity of the PSQI and ESS in older women in the Study of Osteoporotic Fractures (SOF (9)). Total scores for both measures had good internal consistency, but multiple PSQI items and two subscales had low correlations with the total score (9). Advancement of knowledge regarding late-life sleep quality and daytime sleepiness also requires validation of these measures in older men. We evaluated the internal consistency reliability and construct validity of the PSQI and the ESS in a cohort of older men. We hypothesized that greater disturbance on the questionnaires would be associated with (a) poorer objective sleep as measured by greater objectively measured sleep fragmentation and daytime napping; (b) more depressive symptoms, greater mobility/instrumental activity of daily living (IADL) difficulty, and lower health-related quality of life; and (c) the presence of self-reported sleep disorders.

Randomized, double-blind, placebo-controlled crossover trial of modafinil in the treatment of excessive daytime sleepiness in narcolepsy

Abstract: Seventy-five patients meeting international diagnostic criteria for narcolepsy enrolled in a 6-week, three-period, randomized, crossover, placebo-controlled trial. Patients received placebo, modafinil 200 mg, or modafinil 400 mg in divided doses (morning and noon). Evaluations occurred at baseline and at the end of each 2-week period. Compared with placebo, modafinil 200 and 400 mg significantly increased the mean sleep latency on the Maintenance of Wakefulness Test by 40% and 54%, with no significant difference between the two doses. Modafinil, 200 and 400 mg, also reduced the combined number of daytime sleep episodes and periods of severe sleepiness noted in sleep logs. The likelihood of falling asleep as measured by the Epworth Sleepiness Scale was equally reduced by both modafinil dose levels. There were no effects on nocturnal sleep initiation, maintenance, or architecture, nor were there any effects on sleep apnea or periodic leg movements. Neither dose interfered with the patients' ability to nap voluntarily during the day nor with their quantity or quality of nocturnal sleep. Modafinil produced no changes in blood pressure or heart rate in either normotensive or hypertensive patients. The only significant adverse effects were seen at the 400-mg dose, which was associated with more nausea and more nervousness than either placebo or the 200-mg dose. As little as a 200-mg daily dose of modafinil is therefore an effective and well-tolerated treatment of excessive daytime somnolence in narcoleptic persons.

Modafinil as Adjunct Therapy for Daytime Sleepiness in Obstructive Sleep Apnea

Abstract: Patients with obstructive sleep apnea/hypopnea syndrome can experience residual daytime sleepiness despite regular use of nasal continuous positive airway pressure therapy. This randomized, double-blind, placebo-controlled, parallel group study assessed the efficacy and safety of modafinil for the treatment of residual daytime sleepiness in such patients. Patients received modafinil (n = 77) (200 mg/d, Week 1; 400 mg/d, Weeks 2 to 4) or matching placebo (n = 80) once daily for 4 wk. Modafinil significantly improved daytime sleepiness, with significantly greater mean changes from baseline in Epworth Sleepiness Scale scores at Weeks 1 and 4 (p 10 min; 29% versus 25%). Headache (modafinil, 23%; placebo, 11%; p = 0.044) and nervousness (modafinil, 12%; placebo, 3%; p = 0.024) were the most common adverse events. During modafinil or placebo treatment, the mean duration of nCPAP use was 6.2 h/night, with no significant change from baseline observed between groups. Modafinil may be a useful adjunct treatment for the management of residual daytime sleepiness in patients with obstructive sleep apnea/hypopnea syndrome who are regular users of nasal continuous positive airway pressure therapy.