Rühle K H, Kuhtin O, Domanski U, Franke K J, Nilius G
Klinik für Pneumologie, HELIOS-Klinik Ambrock Hagen.
Pneumologie. 2012 Mar;66(3):184-7. doi: 10.1055/s-0031-1291634. Epub 2012 Jan 27.
The Epworth Sleepiness Scale (ESS) describes the likelihood of falling asleep in 8 specific situations. Pathological sleepiness (TS) of patients with obstructive sleep apnea (OSA) is most often diagnosed with an ESS score≥11 (TS-ESS). In an epidemiological study on the prevalence of sleep apnea syndrome (OSAS), only three questions with yes-no answers were used for the characterization of pathological daytime sleepiness (TS-Young): Due to the different construction of the ESS and the Young's questionnaire, we asked whether with the combination of the two questionnaires a larger number of patients with OSA and TS compared to the ESS can be identified. In addition, we examined the sleepiness questionnaires (FB) using objective vigilance in defined groups of OSA patients.
Using PSG 328 OSA patients with an AHI≥5 were identified. Vigilance was examined using the computer program CARDA.
With both FB the same percentage of patients with AHI>5 with pathological sleepiness was found (48 %). By combining both FB (TS-comb), the number of patients increased from 158 (48.2 %) to 195 (59.5 %) significantly. The combination showed a significantly higher percentage with additional 37 (11.3 %) patients in comparison to the TS-ESS alone. Combining both FB, an increase of TS resulted in patients with below-average number of errors in the vigilance test (n=192) from 23.2 % to 31.4 % of these cases (p<0.001).
As a single test both questionnaires can be used to detect daytime sleepiness with equal incidence. Combining both questionnaires a higher percentage of daytime sleepiness can be found in comparison to the ESS-questionnaire alone especially in patients without disturbance of vigilance.
爱泼沃斯思睡量表(ESS)描述了在8种特定情况下入睡的可能性。阻塞性睡眠呼吸暂停(OSA)患者的病理性嗜睡(TS)最常通过ESS评分≥11来诊断(TS-ESS)。在一项关于睡眠呼吸暂停综合征(OSAS)患病率的流行病学研究中,仅使用了三个是非题来表征病理性日间嗜睡(TS-Young):由于ESS和杨氏问卷的构建不同,我们询问将这两种问卷结合使用是否能比单独使用ESS识别出更多的OSA和TS患者。此外,我们在特定组的OSA患者中使用客观警觉性检查了嗜睡问卷(FB)。
使用多导睡眠图(PSG)确定了328例呼吸暂停低通气指数(AHI)≥5的OSA患者。使用计算机程序CARDA检查警觉性。
使用两种FB发现,AHI>5且有病理性嗜睡的患者百分比相同(48%)。通过将两种FB结合(TS-comb),患者数量从158例(48.2%)显著增加到195例(59.5%)。与单独使用TS-ESS相比,这种结合显示另外有37例(11.3%)患者的百分比显著更高。结合两种FB,在警觉性测试中错误数量低于平均水平的患者(n=192)中,TS的发生率从这些病例的23.2%增加到31.4%(p<0.001)。
作为单一测试,两种问卷均可用于以相同发生率检测日间嗜睡。与单独使用ESS问卷相比,结合两种问卷可发现更高百分比的日间嗜睡,尤其是在警觉性未受干扰的患者中。