Division of Pulmonary, Critical Care and Sleep Medicine, University Hospital Case Medical Center and Case Western Reserve University, Cleveland, OH, USA.
J Clin Sleep Med. 2009 Aug 15;5(4):344-8.
African Americans have elevated scores on the Epworth Sleepiness Scale (ESS) compared to whites. The reason for this difference is not clear.
Responses to the ESS were assessed in 687 patients (52.3% African American) referred to a hospital-based sleep clinic. Differences in total ESS score and the scores on individual Epworth questions were compared in African Americans and whites. Findings were validated in an independent sleep apnea research cohort of 712 subjects (57.3% African Americans).
African Americans in the clinic-based population had a higher mean ESS score than whites (11.4 +/- 0.3 vs. 9.8 +/- 0.3, p < 0.0001). This difference persisted after adjusting for sleepiness risk factors. In adjusted analyses including responses to the other ESS questions, African Americans scored significantly greater on 3 of the 8 ESS component questions: questions 2-"Watching TV," 6-"Sitting and talking to someone," and 7-"Sitting quietly after lunch without alcohol." In the validation cohort, African Americans also had a higher mean ESS score (9.1 +/- 0.3, vs. 8.2 +/- 0.3, p = 0.04). In addition they had significantly elevated scores on questions 6 and 7 (p = 0.0002, p = 0.012 respectively) even after adjusting for responses to the other Epworth questions.
African Americans have greater sleepiness than whites as assessed by the ESS; this is independent of sleepiness risk factors. The difference appears due primarily to differences in responses to questions 6 and 7 of the ESS questions suggesting a difference in the interpretation of these 2 questions.
与白人相比，非裔美国人在 Epworth 嗜睡量表（ESS）上的得分较高。造成这种差异的原因尚不清楚。
对就诊于一家医院睡眠诊所的 687 名患者（52.3%为非裔美国人）进行了 ESS 应答评估。比较了非裔美国人和白人的 ESS 总分和个别 Epworth 问题的得分差异。在一个由 712 名受试者（57.3%为非裔美国人）组成的独立睡眠呼吸暂停研究队列中验证了这些发现。
在基于诊所的人群中，非裔美国人的 ESS 平均得分高于白人（11.4 +/- 0.3 对 9.8 +/- 0.3，p < 0.0001）。在调整了嗜睡危险因素后，这种差异仍然存在。在包括对 ESS 其他问题的应答的调整分析中，非裔美国人在 8 个 ESS 组成问题中的 3 个问题上的得分显著更高：问题 2-"看电视"、问题 6-"与他人坐谈"和问题 7-"午饭后安静地坐着，不饮酒"。在验证队列中，非裔美国人的 ESS 平均得分也更高（9.1 +/- 0.3，对 8.2 +/- 0.3，p = 0.04）。此外，即使调整了对其他 Epworth 问题的应答，他们在问题 6 和 7 上的得分也显著升高（p = 0.0002，p = 0.012）。
非裔美国人的嗜睡程度比白人高，这可以通过 ESS 评估来判断；这种差异独立于嗜睡的危险因素。这种差异似乎主要归因于 ESS 问题中问题 6 和 7 的应答差异，这表明这两个问题的解释存在差异。
