Department of Respiratory Medicine, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China; Department of Respiratory Medicine, First People's Hospital of Kunshan, Kunshan, Jiangsu 215300, China.
Chin Med J (Engl). 2013;126(17):3245-50.
Excessive daytime sleepiness (EDS) is often associated with obstructive sleep apnea hypopnea syndrome (OSAHS) and contributes to a number of comorbidities in these patients. Therefore, early detection of EDS is critical in disease management. We examined the association between Epworth Sleepiness Scale (ESS) and multiple sleep latency test (MSLT) and diagnostic accuracy of ESS in assessing EDS in OSAHS patients.
The ESS, MSLT and overnight polysomnography were administered to 107 Chinese patients to assess EDS and its correlations with polysomnographic parameters. The diagnostic accuracy of ESS in classifying EDS (mean sleep latency (MSL) ≤ 10 minutes) was evaluated by calculating the area under ROC curve.
As the severity of OSAHS increased, MSL decreased with increase in ESS score. Conversely, patients with worsening EDS (shorter MSL) were characterized by advanced nocturnal hypoxaemia and sleep disruption compared to those with normal MSL, suggesting EDS is associated with more severe OSAHS. There was a negative correlation between ESS score and MSL and both moderately correlated with some polysomnographic nocturnal hypoxaemic parameters. The area under ROC curve of ESS for identifying EDS was 0.80 (95% CI: 0.71 to 0.88) and ESS score ≥ 12 provided the best predictive value with a sensitivity of 80% and specificity of 69%.
The ESS score moderately correlates with MSL and our ROC study supports ESS as a screening strategy for assessing EDS in OSAHS.
日间过度嗜睡（EDS）常与阻塞性睡眠呼吸暂停低通气综合征（OSAHS）相关，并导致这些患者出现许多合并症。因此，早期发现 EDS 对于疾病管理至关重要。我们研究了 Epworth 睡眠量表（ESS）和多次睡眠潜伏期试验（MSLT）之间的关系，以及 ESS 评估 OSAHS 患者 EDS 的诊断准确性。
对 107 例中国患者进行 ESS、MSLT 和整夜多导睡眠图检查，以评估 EDS 及其与多导睡眠图参数的相关性。通过计算 ROC 曲线下面积来评估 ESS 对 EDS（平均睡眠潜伏期（MSL）≤10 分钟）的分类诊断准确性。
随着 OSAHS 严重程度的增加，MSL 随 ESS 评分的增加而降低。相反，与 MSL 正常的患者相比，EDS 恶化（MSL 更短）的患者表现出更严重的夜间低氧血症和睡眠中断，提示 EDS 与更严重的 OSAHS 相关。ESS 评分与 MSL 呈负相关，与一些多导睡眠图夜间低氧参数中度相关。ESS 用于识别 EDS 的 ROC 曲线下面积为 0.80（95%CI：0.71 至 0.88），ESS 评分≥12 具有最佳预测值，其敏感性为 80%，特异性为 69%。
ESS 评分与 MSL 中度相关，我们的 ROC 研究支持 ESS 作为评估 OSAHS 患者 EDS 的筛查策略。
