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.

Positioner--a method for preventing sleep apnea.

Abstract: Conclusions. A ‘Positioner’ preventing sleeping on the back can effectively reduce obstructive sleep apnea (OSA), but not always snoring for patients with long-term OSA. By preference, the device should be used for younger snorers without OSA as a training tool to avoid sleeping on the back. Instructions and support by a nurse are necessary for compliance. Objectives. Snoring is a progressive condition with a prevalence of 2530% among the adult male population. Long-term snoring seems to be the basis for apneas caused by vibration damage to the pharyngeal tissue. Patients with OSA often have more apneas in the supine position than in the lateral position. Preventing sleeping on the back is a way to treat OSA. The aim of this study was to evaluate the efficacy and comfort of a recently developed Positioner. Subjects and methods. A total of 23 patients diagnosed with positional sleep apnea (AHI� /15 in supine position and AHI B /5 in lateral position), were included. The Positioner a soft vest, attached to a board placed under the pillow, makes it impossible for the patient to sleep on his back. It was fitted and tried out individually. Patients answered sleep questionnaires and kept sleep diaries before beginning use. After 3 months, a new sleep study was done while using the Positioner and new questionnaires were filled out. Results. Eighteen patients (5 women and 13 men) completed the study. The rest could not tolerate being strapped into the Positioner. Of those participating, 61% demonstrated a decrease of AHI to B /10 using the Positioner. The Epworth Sleepiness Scale (ESS) decreased from a mean of 12.3 to 10.2. Half of the patients snored more frequently with the Positioner. The evaluation of comfort showed that minor adjustments are desirable.

Subjective and objective sleepiness in monozygotic twins discordant for chronic fatigue syndrome.

Abstract: STUDY OBJECTIVE To examine the association of chronic fatigue syndrome (CFS) with measures of objective and subjective sleepiness. DESIGN Monozygotic co-twin control study. SETTING Academic medical center. PATIENTS AND PARTICIPANTS Twenty monozygotic twin pairs discordant for CFS. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS All twins completed an Epworth Sleepiness Scale (ESS), 4 Stanford Sleepiness Scales (SSS), and underwent a standard 4-nap multiple sleep latency test. We compared the ESS scores, average SSS scores, and average sleep latency in CFS and healthy twins. The CFS twins reported more sleepiness as measured by mean scores on the ESS (10.9 vs 8.2; 95% confidence interval [CI] = 0.3-5.5; P = .03) and the SSS (3.4 versus 2.1; 95% CI = 0.7-1.9; P < .001). The mean sleep latency on the Multiple Sleep Latency Test was not significantly different between the CFS and healthy twins (8.9 vs 10.0 minutes; 95% CI -4.4-1.7; P = .33). Mean SSS scores increased among the CFS twins and decreased among healthy twins from nap 1 to nap 4 (P < .001). The individual ESS scores and mean sleep latencies on the Multiple Sleep Latency Test were negatively correlated for all the twins (Pearson's r = - 0.40; P = .01), with a slightly stronger association among the healthy twins (Pearson's r = -0.42, P = .07) than the CFS twins (Pearson's r = -0.36, P = .15). CONCLUSIONS CFS twins reported significantly more subjective sleepiness than their healthy co-twins despite similar nonpathologic mean sleep latencies on the Multiple Sleep Latency Test. Patients with CFS may mistake their chronic disabling fatigue for sleepiness.

Modafinil for Parkinson's disease fatigue.

Abstract: Fatigue is common in Parkinson's disease (PD), occurring in up to 42% of patients (2). There is no recognized treatment. This is a study of modafinil for Parkinson's disease related fatigue. Ethical approval was given. Patients with idiopathic PD were recruited from a Movement Disorders clinic. Those with depression, dementia, and other causes for fatigue were excluded. Patients were assessed using the Fatigue Severity Scale (FSS), Hospital Anxiety and Depression Scale (HADS), self-rating of improvement, Epworth Sleepiness Scale (ESS), and UPDRS. Modafinil was titrated up over 4 weeks to maximum of 400 mg/day. There followed a 5 week maintenance phase before reassessment. Thirteen patients participated. No significant change was seen in any safety measure. The FSS did not change significantly, however those on modafinil rated an improvement in their fatigue compared to placebo. The Modafinil group had a statistically significant improvement on ESS (p < 0.05). This is a small study of modafinil in selected PD patients. There is a suggestion of improvement on the global clinical impression scale for fatigue, but no significant change on FSS. A larger study is needed to further evaluate this drug in PD fatigue. This study highlights the problems with recruitment when trialing treatments of non-motor symptoms in PD. A significant improvement in EDS was seen.

Clinical assessment of nocturnal disability in Parkinson’s disease: The Parkinson’s Disease Sleep Scale

Abstract: Research by our group and by others suggests that sleep disturbances are common in Parkinson’s disease (PD) and can occur at all stages of PD, and that virtually all PD patients suffer from varying levels of nocturnal disability causing sleep disruption.1–4⇓⇓⇓ The etiology is likely to be diverse, and includes degeneration of central sleep regulatory centers and the effect(s) of dopaminergic drugs.2,5⇓ The problem of nocturnal symptoms in PD is compounded by the fact that such symptoms arise from a multitude of causes, categorized as insomnia, motor, urinary, and neuropsychiatric symptoms, often with secondary daytime somnolence, and occasionally in the form of “sleep attacks,” although this remains controversial.6,7⇓ Conventional sleep assessment is based on anamnesis, caregiver or spouse reports, patients’ diaries, the usual PD rating scales, polysomnography, or video recordings.8 Currently available scales for measuring disability, such as the Unified Parkinson’s Disease Rating Scale (UPDRS),9 do not allow a formal clinimetric approach or do not provide a holistic assessment of sleep-related problems in PD. The newly developed and validated Parkinson’s Disease Sleep Scale (PDSS),10,11⇓ the first specific instrument designed to measure sleep disturbances in PD, aims to provide a bedside/clinical holistic measure of the nocturnal symptom complex of PD in a semi-quantitative manner. The gold standards for physiologic measurement of sleep and sleep parameters are polysomnography (PSG) and multiple sleep latency tests (MSLT). However, these tests measure sleep architecture, require measurements in specialized sleep laboratories, and are relatively expensive. Furthermore, they may not provide information on causes of sleep disabilities such as nocturnal tremor, nocturia, or akinesia. The Epworth Sleepiness Scale (ESS) has been widely used but is not specific to PD and measures only daytime somnolence.12 Problems with the use of ESS in PD include intercultural …