The Diagnostic Values Of Epworth Sleepiness Scale And MSLT In Measuring Excessive Daytime Sleepiness In Patients With OSAHS

Objective:To evaluate the diagnostic values of Epworth sleepiness scale (ESS) and multiple sleep latency test(MSLT) in measuring excessive daytime sleepiness (EDS) in patients suffered from obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:Eighty-three cases with suspected OSAHS were enrolled, of which the EDS extent measured by ESS, a five-nap MSLT, and polysomnography (PSG) were analyzed. Based on their value of apnea hypopnea index (AHI) assessed by PSG, the patients were categorized into the primary snoring group, mild-moderate OSAHS group and severe OSAHS group. The ESS scales, MSLT datas and other sleep parameters were compared among different groups. The correlation of polysomnography (PSG) monitoring datas with ESS scores and MSLT datas was analyzed. According to the assessment of MSLT score, all cases were divided into three groups: normal, moderate and severe EDS groups. The ESS scores in different EDS groups and the correlation between ESS and MSLT were analyzed. The diagnostic value of ESS score in EDS were evaluated by ROC curve.Results:The mild-moderate OSAHS group had significantly shorter mean sleep latency (10.98±5.18min) than the normal (14.09±3.43 min); and at the same time, the severe group (6.83±3.12 min) is also significantly shorter than the mild-moderate group (10.98±5.18min). However, there was no significant difference in their ESS scores. Only MSLT was found to be significantly correlated with the REM latency, the proportion of slow wave sleep and REM sleep. ESS was negatively related to MSL (r=-0.369). The area under the ROC curve of ESS used to diagnosis EDS was 0.762. The severe EDS group had significantly higher ESS score(17.58±3.99) than the normal(8.36±5.84) (P<0.05). The area under ROC curve of ESS used to diagnosis OSAHS is 0.775.Conclusions:MSLT was better than ESS in reflecting the severity of daytime sleepiness in OSAHS. ESS can primarily screen EDS in patients with OSAHS, however the value for diagnosis was limited.