Year: 2002
Type: article
Abstract: Introduction: Recently, the criteria for the diagnosis of OSA were recommended as the presence of physiological impairment as well as the manifestation of excessive daytime sleepiness (EDS). 1 However, the extent that sleepiness is characteristic of this population and the primary method of measuring daytime sleepiness remains unresolved.It is also unclear how many of those with more severe disease fail to manifest either objective or subjective sleepiness and therefore may not be candidates for treatment.1 The purpose of this study was to describe the profile of sleepiness in subjects with moderate/severe OSA and to examine the consistency and proportion of subjects that manifest sleepiness based on three conceptually distinct measures: a measure of subjective sleepiness (Epworth Sleepiness scale [ESS]), 2 objective sleepiness (Multiple Sleep Latency Test [MSLT]), and of sustained attention (Psychomotor Vigilance Task [PVT]).3 Methods: Subjects participated in a multisite study where inclusion criteria were ages 20-60, clinical judgment of EDS, RDI ≥ 20, and a candidate for CPAP.Exclusion criteria included any co-existing sleep disorder or co-morbidity that would affect daily functioning.Subjects completed a battery of outcome measures that included the ESS, MSLT, and PVT at baseline and again following 3 mo. of CPAP use.Subjects with complete data for the ESS, MSLT, and PVT were included in these analyses ( N = 107).Sleepy subjects were differentiated from non-sleepy subjects for each of these measures based on the following cut-points: ESS ≥ 11; MSLT < 10; and presence of ≥ 2 performance lapses/10 min.on the PVT.Results: The sample (92% male, 87% white, mean underSD age = 45.9, ± 8.9, mean BMI 38.7 ± 8.6, mean RDI = 66 ± 31) had a mean ESS = 14.1 ± 4.8, mean MSLT sleep latency = 7.3 ± 5.2, and a mean PVT total lapses = 4.5 ± 8.4.As shown in the table, approximately half of the subjects manifested sleepiness both subjectively and objectively when the MSLT was used to measure objective sleepiness, with approximately a third of the patients manifesting subjective and objective sleepiness when the PVT measured objective sleepiness.Only 29% exhibited sleepiness on all three measures.Thirteen percent of the sample failed to manifest any sleepiness measured either subjectively or objectively.There was a low correlation between the ESS and either the MSLT (r = 0.26, p = 0.0009) or the PVT (r = 0.19, p = 0.04); there was no significant correlation between PVT and the MSLT (r = 0.06).
Language: English
Subfield: Physiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W65523988