Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia.
Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia.
Sleep Breath. 2021 Dec;25(4):2179-2187. doi: 10.1007/s11325-020-02269-w. Epub 2021 Jan 6.
Since disagreement has been found between an objective sleep propensity measured by sleep onset latency (SOL) and subjective sleepiness assessment measured by the Epworth sleepiness scale (ESS) score, distinct underlying causes and consequences were suggested for these two sleepiness measures. We addressed the issue of validation of the ESS against objective sleepiness and sleep indexes by examining the hypothesis that these two sleepiness measures are disconnected due to their differential relationship with the antagonistic drives for sleep and wake.
The polysomnographic records of 50-min napping attempts were collected from 27 university students on three occasions. Scores on the first and second principal components of the electroencephalographic (EEG) spectrum were calculated to measure the sleep and wake drives, respectively. Self-assessments of subjective sleepiness and sleep were additionally collected in online survey of 633 students at the same university.
An ESS score was disconnected with the polysomnographic and self-assessed SOL in the nap study and online survey, respectively. An ESS score but not SOL was significantly linked to the spectral EEG measure of the sleep drive, while SOL but not ESS showed a significant association with the spectral EEG measure of the opposing wake drive.
Each of two sleepiness measures was validated against objective indicators of the opposing sleep-wake regulating processes, but different underlying causes were identified for two distinct aspects of sleepiness. A stronger sleep drive and a weaker opposing drive for wake seem to contribute to a higher ESS score and to a shorter SOL, respectively.
由于客观睡眠倾向的测量指标（入睡潜伏期，SOL）与主观嗜睡评估的测量指标（Epworth 嗜睡量表，ESS 评分）之间存在分歧，因此提出了这两种嗜睡测量指标的不同潜在原因和后果。我们通过检验以下假设来解决 ESS 与客观嗜睡和睡眠指标的验证问题，即这两种嗜睡测量指标之间存在差异，因为它们与睡眠和觉醒的拮抗驱动力具有不同的关系。
在三次实验中，共收集了 27 名大学生 50 分钟的小睡记录。计算脑电图（EEG）频谱的前两个主成分的得分，以分别测量睡眠和觉醒驱动力。此外，还在同一所大学的 633 名学生的在线调查中收集了自我评估的主观嗜睡和睡眠数据。
ESS 评分与小睡研究和在线调查中的多导睡眠图和自我评估的 SOL 均无关联。ESS 评分与睡眠驱动力的 EEG 频谱测量显著相关，但与觉醒驱动力的 EEG 频谱测量不相关，而 SOL 评分与 EEG 测量显著相关。
两种嗜睡测量指标均与睡眠-觉醒调节过程的客观指标相关，但两种嗜睡的不同方面有不同的潜在原因。更强的睡眠驱动力和更弱的觉醒拮抗驱动力似乎分别导致 ESS 评分升高和 SOL 缩短。
