Olson L G, Cole M F, Ambrogetti A
Sleep Disorders Centre, Royal Newcastle Hospital, NSW, Australia.
J Sleep Res. 1998 Dec;7(4):248-53. doi: 10.1046/j.1365-2869.1998.00123.x.
The aim of this study was to identify factors other than objective sleep tendency associated with scores on the Epworth Sleepiness Scale (ESS). There were 225 subjects, of whom 40% had obstructive sleep apnoea (OSA), 16% had simple snoring, and 4.9% had snoring with sleep disruption (upper airway resistance syndrome); 9.3% had narcolepsy and 7.5% had hypersomnolence without REM sleep abnormalities; 12% had chronic fatigue syndrome; 7.5% had periodic limb movement disorder and 3% had diurnal rhythm disorders. ESS, the results of overnight polysomnography and multiple sleep latency test (MSLT) and SCL-90 as a measure of psychological symptoms were recorded. The ESS score and the mean sleep latency (MSL) were correlated (Spearman rho = -0.30, P < 0.0001). The MSL was correlated with total sleep time (TST) and with sleep efficiency but not with apnoea/hypopnoea index. There was no association between the MSL and any aspect of SCL-90 scores, except a borderline significant association with the somatisation subscale. The ESS was correlated with TST but not with sleep efficiency or apnoea/hypopnoea index. The ESS was correlated with all subscales of the SCL-90 except psychoticism. An ESS > or = 10 had poor sensitivity and specificity as a predictor of MSL < 10 min or MSL < 5 min. We conclude that the MSLT and the ESS are not interchangeable. The ESS was influenced by psychological factors by which the MSL was not affected. The ESS cannot be used to demonstrate or exclude sleepiness as it is measured by MSLT.
本研究的目的是确定与Epworth嗜睡量表（ESS）得分相关的、除客观睡眠倾向以外的其他因素。共有225名受试者，其中40%患有阻塞性睡眠呼吸暂停（OSA），16%有单纯打鼾，4.9%有伴有睡眠中断的打鼾（上气道阻力综合征）；9.3%患有发作性睡病，7.5%患有无快速眼动睡眠异常的过度嗜睡；12%患有慢性疲劳综合征；7.5%患有周期性肢体运动障碍，3%患有昼夜节律障碍。记录了ESS、夜间多导睡眠图和多次睡眠潜伏期试验（MSLT）的结果以及作为心理症状指标的SCL-90。ESS得分与平均睡眠潜伏期（MSL）相关（斯皮尔曼相关系数rho=-0.30，P<0.0001）。MSL与总睡眠时间（TST）和睡眠效率相关，但与呼吸暂停/低通气指数无关。MSL与SCL-90得分的任何方面均无关联，仅与躯体化分量表有边缘性显著关联。ESS与TST相关，但与睡眠效率或呼吸暂停/低通气指数无关。ESS与SCL-90的所有分量表相关，但与精神质分量表无关。ESS≥10作为MSL<10分钟或MSL<5分钟的预测指标时，敏感性和特异性较差。我们得出结论，MSLT和ESS不可互换。ESS受心理因素影响，而MSL不受其影响。ESS不能用于证明或排除由MSLT所测量的嗜睡情况。
