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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.
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TL;DR: It is concluded that short‐term (2‐month) improvements in sleep predicted long-term (9‐ and 18‐ month) improvements for multiple measures of sleep, chronic pain, and fatigue, and these improvements were not attributable to nonspecific benefits for psychological well‐being, such as reduced depression.
Abstract: In a primary care population of 367 older adults (age 60+) with osteoarthritis (OA) pain and insomnia, we examined the relationship between short-term improvement in sleep and long-term sleep, pain and fatigue outcomes through secondary analyses of randomized controlled trial data. Study participants, regardless of experimental treatment received, were classified as either Improvers (≥30% baseline to 2-month reduction on the Insomnia Severity Index [ISI]) or Non-Improvers. After controlling for treatment arm and potential confounders, Improvers showed significant, sustained improvements across 18 months compared to Non-Improvers in Pain Severity (p<.001, Adjusted Mean Difference = −0.51 [95% Confidence Interval: −0.80, −0.21]), Arthritis Symptoms (p<.001, 0.63 [0.26, 1.00]), and Fear Avoidance (p=.009, −2.27 [−3.95, −0.58]) but not in Catastrophizing or Depression. Improvers also showed significant, sustained improvements in ISI (p<.001, −3.03 [−3.74, −2.32]), Pittsburgh Sleep Quality Index Total (p<.001, −1.45 [−1.97, −0.93]) and General Sleep Quality (p<.001, −.28 [−.39, −.16]) scores, Flinders Fatigue Scale (p<.001, −1.99 [−3.01, −0.98]), and Dysfunctional Beliefs about Sleep (p=.037, −2.44 [−4.74, −0.15]), but no improvements on the Functional Outcomes of Sleep Questionnaire or the Epworth Sleepiness Scale. We conclude that short-term (2-month) improvements in sleep predicted long-term (9- and 18-month) improvements for multiple measures of sleep, chronic pain, and fatigue. These improvements were not attributable to non-specific benefits for psychological well-being such as reduced depression. These findings are consistent with benefits of improved sleep for chronic pain and fatigue among older persons with osteoarthritis pain and co-morbid insomnia if robust improvements in sleep are achieved and sustained.
146 citations
TL;DR: There was significant improvement in neurobehavioral function in children after 3 months of positive airway pressure therapy, even in developmentally delayed children, and the implications for improved family, social, and school function are substantial.
Abstract: Rationale: Positive airway pressure therapy is frequently used to treat obstructive sleep apnea in children. However, it is not known whether positive airway pressure therapy results in improvements in the neurobehavioral abnormalities associated with childhood sleep apnea.Objectives: We hypothesized that positive airway pressure therapy would be associated with improvements in attention, sleepiness, behavior, and quality of life, and that changes would be associated with therapy adherence.Methods: Neurobehavioral assessments were performed at baseline and after 3 months of positive airway pressure therapy in a heterogeneous group of 52 children and adolescents.Measurements and Main Results: Adherence varied widely (mean use, 170 ± 145 [SD] minutes per night). Positive airway pressure therapy was associated with significant improvements in attention deficits (P < 0.001); sleepiness on the Epworth Sleepiness Scale (P < 0.001); behavior (P < 0.001); and caregiver- (P = 0.005) and child- (P < 0.001) reported...
146 citations
TL;DR: The data confirmed the high frequency of depressive symptoms and the major impact of central hypersomnias on health related quality of life, especially in patients with cataplexy and recommends a more thorough assessment of mood impairment in central hypersOMnias,especially in narcolepsy–cataplexY.
Abstract: Background: A large observational French study of central hypersomnia, including narcolepsy with cataplexy (C+), without cataplexy (C−) and idiopathic hypersomnia (IH), was conducted to clarify the relationships between the severity of the condition, psychological health and treatment response. Methods: 601 consecutive patients over 15 years of age suffering from central hypersomnia were recruited on excessive daytime sleepiness, polysomnography and Multiple Sleep Latency Test (MSLT) results. 517 (47.6% men, 52.4% women) were finally included: 82.0% C+, 13.2% C− and 4.8% IH. Face to face standardised clinical interviews plus questionnaires (Epworth Sleepiness Scale (ESS), short version Beck Depression Inventory (S-BDI), Pittsburgh Sleep Quality Index (PSQI) and 36-item Short Form Health Survey (SF-36)) were performed. Patients affected with a different diagnosis and with and without depressive symptoms were compared. Results: Mean ESS and body mass index were higher in C+ compared with C−/IH patients. Half of the patients (44.9%) had no depressive symptoms while 26.3% had mild, 23.2% moderate and 5.6% severe depressive symptoms. C+ patients had higher S-BDI and PSQI and lower SF-36 scores than C−/IH patients. Depressed patients had higher ESS scores than non-depressed patients, with no difference in age, gender, duration of disease or MSLT parameters. Finally, C+ patients treated with anticataplectic drugs (38.7%) had higher S-BDI and lower SF-36 scores than C+ patients treated with stimulants alone. Conclusion: Our data confirmed the high frequency of depressive symptoms and the major impact of central hypersomnias on health related quality of life, especially in patients with cataplexy. We recommend a more thorough assessment of mood impairment in central hypersomnias, especially in narcolepsy–cataplexy.
145 citations
TL;DR: While there were sporadic statistically significant differences identified, a clear beneficial pattern was not seen at either week 4 or week 10 for any of the 12 outcomes, and there was no consistent and persistent clinically significant difference between treatment with modafinil and placebo.
Abstract: Background This study examines the efficacy of modafinil in treating fatigue and excessive daytime sleepiness in individuals with traumatic brain injury (TBI). Methods A single-center, double-blind, placebo-controlled cross-over trial, where 53 participants with TBI were randomly assigned to receive up to 400 mg of modafinil, or equal number of inactive placebo tablets. Main eligibility criteria were being at least 1 year post-TBI severe enough to require inpatient rehabilitation. The primary outcome measures were fatigue (Fatigue Severity Scale, FSS) and daytime sleepiness (Epworth Sleepiness Scale, ESS). Results After adjusting for baseline scores and period effects, there were no statistically significant differences between improvements seen with modafinil and placebo in the FSS at week 4 (-0.5 +/- 1.88; P = .80) or week 10 (-1.4 +/- 2.75; P = .61). For ESS, average changes were significantly greater with modafinil than placebo at week 4 (-1.2 +/- 0.49; P = .02) but not at week 10 (-0.5 +/- 0.87; P = .56). Modafinil was safe and well tolerated, although insomnia was reported significantly more often with modafinil than placebo (P = .03). Conclusions While there were sporadic statistically significant differences identified, a clear beneficial pattern from modafinil was not seen at either week 4 or week 10 for any of the 12 outcomes. There was no consistent and persistent clinically significant difference between treatment with modafinil and placebo.
145 citations
TL;DR: Although CPAP has a greater treatment effect, MAD is an appropriate treatment for patients who are intolerant of CPAP and may be comparable to CPAP in mild disease.
145 citations