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Revista americana de medicina respiratoria

On-line version ISSN 1852-236X


BORSINI, Eduardo et al. Relación entre la escala de somnolencia de Epworth y el índice de apneas e hipoapneas de la poligrafía respiratoria. Rev. amer. med. respiratoria [online]. 2013, vol.13, n.3, pp.123-132. ISSN 1852-236X.

Objectives: To identify the value in the Epworth Sleepiness scale (ESS) that correlates best with an apnea/hypopnea index (AHI) greater than 15/h in the respiratory polygraphy (RP) in patients referred to a sleep clinic with suspicion of obstructive sleep apnea (OSA). Materials and Methods: This is a study conducted between January 2010 and March 2012 in a cohort of 614 patients referred for sleep evaluation. Respiratory polygraphy (level III) was performed at home with a self-electrode placement technique. Anthropometric data, Berlin questionnaire score, and ESS score were correlated with an AHI greater than 15/h. A logistic regression analysis was performed for prediction factors for AHI > 15/h, and different cut-off points for ESS were tried out as an independent predictor. Finally an area under the ROC curve was calculated. Results: 614 patients were studied, 392 males (63.8%) and 222 females with a mean age of 54.9 years. Obesity (BMI > 30) was present in 57.7%. Berlin questionnaire registered high risk in 536 cases (87.3), while 207 (33.7%) subjects had an ESS score > 10 points. In 235 RP an AHI > 15/h (38.27%) was found. The analysis for independent predictors showed significance for male gender (p = 0.0001), BMI > 30 (p = 0.0001), and age > 50 years (p = 0.0001). In a univariate analysis ESS score > 8 had an OR of 1.29 (CI 0.93-1.79), ESS score > 10 had and OR of 1.52 (CI 1.08-2.14), ESS score > 11 had an OR of 1.61 (CI 1.13-2.28), and ESS score > 12 had an OR of 1.46 (CI 0.99-2.15). The multivariate analysis including age > 50, presence of a psychiatric condition, BMI > 30, and high risk Berlin questionnaire showed that ESS > 11 had an OR of 1.53 (CI 1.04-2.24). The area under the ROC curve for ESS > 11 was 0.56, with sensitivity of 34.7% and specificity of 75.1%. Conclusions: ESS is a test with acceptable specificity and low sensitivity. In our patients evaluated with RP for suspicion of OSA, an ESS > 11 correlates best with an AHI > 15/h

Keywords : Respiratory polygraphy; Epworth scale; Sleepiness.

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