Feng Xujun, Shi Yuan, Zhang Ye, Lei Fei, Ren Rong, Tang Xiangdong
Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.
Nat Sci Sleep. 2024 Dec 31;16:2299-2309. doi: 10.2147/NSS.S490960. eCollection 2024.
This study aimed to evaluate the test-retest reliability of the Epworth Sleepiness Scale (ESS) in patients with untreated obstructive sleep apnea (OSA) and investigate the effects of different follow-up techniques and various factors on ESS score discrepancies.
This study prospectively enrolled participants diagnosed with OSA at West China Hospital of Sichuan University from October 2022 to May 2023. Each participant completed a polysomnography (PSG) and the Chinese version of the ESS. Initial ESS evaluations were performed before the PSG and were reassessed either face-to-face or on telephone within a week. Analysis involved Bland-Altman plots, the intraclass correlation coefficient (ICC), and calculation of mean differences.
We included 382 patients with untreated OSA, averaging 43.52 years old, with a mean body mass index (BMI) of 26.54 kg/m and an average apnea-hypopnea index (AHI) of 47.93 events/hour. The ICC was recorded at 0.820. The signed difference in ESS scores from baseline to follow-up was 1.68 ± 2.93 overall. In OSA patients with a BMI > 28, the difference was 2.39 ± 3.46, while in those with an AHI ≥ 30, it was 1.77 ± 3.27.
This study underscores the significance of repeated ESS testing to improve the reliability of sleepiness evaluations in patients with OSA. Further studies should aim to confirm these findings in a broader demographic and develop refined methods for more precise sleepiness assessments among different OSA groups.
本研究旨在评估爱泼沃斯思睡量表（ESS）在未经治疗的阻塞性睡眠呼吸暂停（OSA）患者中的重测信度，并调查不同随访技术和各种因素对ESS评分差异的影响。
本研究前瞻性纳入了2022年10月至2023年5月在四川大学华西医院被诊断为OSA的参与者。每位参与者均完成了多导睡眠图（PSG）检查和中文版ESS。在PSG检查前进行初始ESS评估，并在一周内通过面对面或电话方式进行重新评估。分析包括Bland-Altman图、组内相关系数（ICC）以及平均差异计算。
我们纳入了382例未经治疗的OSA患者，平均年龄43.52岁，平均体重指数（BMI）为26.54kg/m，平均呼吸暂停低通气指数（AHI）为47.93次/小时。ICC记录为0.820。从基线到随访时ESS评分的差异总体为1.68±2.93。在BMI>28的OSA患者中，差异为2.39±3.46，而在AHI≥30的患者中，差异为1.77±3.27。
本研究强调了重复进行ESS测试对于提高OSA患者嗜睡评估可靠性的重要性。进一步的研究应旨在在更广泛的人群中证实这些发现，并开发更精细的方法以在不同OSA组中进行更精确的嗜睡评估。
