患者自评及配偶评的爱泼沃斯思睡量表评分在阻塞性睡眠呼吸暂停评估中的效用。
The utility of patient-completed and partner-completed Epworth Sleepiness Scale scores in the evaluation of obstructive sleep apnea.
作者信息
Bhat Sushanth, Upadhyay Hinesh, DeBari Vincent A, Ahmad Muhammad, Polos Peter G, Chokroverty Sudhansu
机构信息
JFK Neuroscience Institute/Seton Hall University, 65 James Street, Edison,, NJ, 08818, USA.
Seton Hall University, 400 South Orange Avenue, South Orange, NJ, 07079, USA.
出版信息
Sleep Breath. 2016 Dec;20(4):1347-1354. doi: 10.1007/s11325-016-1370-8. Epub 2016 Jun 15.
PURPOSE
Excessive daytime sleepiness in obstructive sleep apnea (OSA) is often rated differently by patients and their partners. This cross-sectional study compared the utility of patient-completed and partner-completed Epworth Sleepiness Scale (ESS) scores in the evaluation of suspected OSA.
METHODS
Eighty-five patient-partner pairs were enrolled, and 75 patients completed diagnostic sleep studies. The individual and combined utilities of patient-completed and partner-completed ESS scores in identifying OSA and predicting various sleep study-derived indicators of disease severity were determined.
RESULTS
Mean partner-completed ESS scores were higher than patient-completed ESS scores (12.3 ± 4.2 vs. 9.4 ± 4.8, p < 0.0001); Bland-Altman plot showed significant bias (partner-completed ESS scores 33.5 % higher, SD ±55.2 %). Partner-completed and combined (but not patient-completed) ESS scores correlated weakly with the apnea-hypopnea index (AHI; partner-completed ESS score r = 0.25, p = 0.029; combined ESS score r = 0.29, p = 0.013) and oxygen desaturation index (partner-completed ESS score r = 0.26, p = 0.025; combined ESS score r = 0.23, p = 0.047). None of the ESS scores correlated with body mass index, arousal index, or other parameters of nocturnal oxygen desaturation. In OSA (AHI > 15/h) detection, partner-completed ESS scores had greater sensitivity than patient-completed ESS scores (76.9 vs. 46.2 %) but poorer specificity (39.1 vs. 65.2 %); sensitivity was greatest (82.7 %) when either patient-completed or partner-completed ESS score was 10 or higher, and specificity was greatest (80.8 %) when both scores were 10 or higher.
CONCLUSIONS
Neither patient-completed nor partner-completed ESS scores by themselves have great utility in identifying OSA or predicting its severity. However, taking both scores into consideration together improves the sensitivity and specificity of the screening process.
目的
阻塞性睡眠呼吸暂停（OSA）患者白天过度嗜睡的程度，患者及其伴侣的评价往往存在差异。这项横断面研究比较了患者自评和伴侣代评的爱泼沃斯嗜睡量表（ESS）评分在疑似OSA评估中的效用。
方法
招募了85对患者-伴侣，其中75名患者完成了诊断性睡眠研究。确定了患者自评和伴侣代评ESS评分在识别OSA以及预测各种源自睡眠研究的疾病严重程度指标方面的个体效用和综合效用。
结果
伴侣代评的ESS平均得分高于患者自评得分（12.3±4.2对9.4±4.8，p<0.0001）；布兰德-奥特曼图显示存在显著偏差（伴侣代评的ESS得分高33.5%，标准差±55.2%）。伴侣代评的ESS评分以及两者综合的ESS评分（而非患者自评的ESS评分）与呼吸暂停低通气指数（AHI；伴侣代评的ESS评分r = 0.25，p = 0.029；综合ESS评分r = 0.29，p = 0.013）和氧饱和度下降指数（伴侣代评的ESS评分r = 0.26，p = 0.025；综合ESS评分r = 0.23，p = 0.047）的相关性较弱。ESS评分与体重指数、觉醒指数或夜间氧饱和度下降的其他参数均无相关性。在检测OSA（AHI>15次/小时）时，伴侣代评的ESS评分比患者自评的ESS评分具有更高的敏感性（76.9%对46.2%），但特异性较差（39.1%对65.2%）；当患者自评或伴侣代评的ESS评分≥10分时，敏感性最高（82.7%），当两者评分均≥10分时，特异性最高（80.8%）。
结论
单独的患者自评或伴侣代评ESS评分在识别OSA或预测其严重程度方面效用不大。然而，综合考虑两者评分可提高筛查过程的敏感性和特异性。
Zotero 插件