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Volume 15 No. 01
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Accepted Papers





Scientific Investigations

Correlation of the Epworth Sleepiness Scale and Sleep-Disordered Breathing in Men and Women

Melissa C. Lipford, MD1,2; Dietlind L. Wahner-Roedler, MD3; Gail A. Welsh, MD3; Jay Mandrekar, PhD4; Prabin Thapa4; Eric J. Olson, MD1,5
1Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota; 2Department of Neurology, Mayo Clinic, Rochester, Minnesota; 3Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota; 4Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota; 5Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota

Study Objectives:

To compare Epworth Sleepiness Scale (ESS) scores of men and women and determine if there is a correlation with sleep-disordered breathing (SDB) based on subsequent polysomnography (PSG).

Methods:

Consecutive adult patients were identified who completed ESS and PSG at Mayo Clinic in Rochester, Minnesota, between January 1, 2013, and January 31, 2015. Apnea-hypopnea index (AHI) ≥ 5 events/h was classified as presence of SDB, and increasing values represented greater severity.

Results:

Among 6,593 patients with valid ESS scores and timely subsequent PSG, 42% were women. Mean (standard deviation [SD]) age of women was 56.2 (15.2) years; men, 58.5 (15.1) years. Mean (SD) ESS score was 9.5 (5.4) for women and 9.5 (5.3) for men. SDB was present in 83.6% of men and 68.3% of women. Mean (SD) AHI of men was 25.9 (26.7) events/h; women, 16.1 (22.4) events/h (P < .001). Each unit increase in ESS score of men was associated with a 0.51-unit increase in AHI (P < .001); women had a 0.16-unit associated increase (P = .04) (effect ratio, threefold greater for men). PSG demonstrated that women had greater sleep efficiency, less respiratory effort-related arousals, and less hypoxemia (all P < .001). Among women, ESS did not correlate with presence of SDB or mild to moderate SDB. There was a small association in women with severe SDB.

Conclusions:

ESS is not correlated with SDB at mild to moderate levels in women and has a smaller association than in men with severe SDB. Further work is necessary to understand sex-specific differences in patients with SDB.

Citation:

Lipford MC, Wahner-Roedler DL, Welsh GA, Mandrekar J, Thapa P, Olson EJ. Correlation of the Epworth Sleepiness Scale and sleep-disordered breathing in men and women. J Clin Sleep Med. 2019;15(1):33–38.




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