PURPOSE: The Epworth Sleepiness Scale is a simple tool for screening of excessive daytime sleepiness, and has been used as a screening tool for obstructive sleep apnea (OSA) among children. The purpose of this study is to assess the reliability of Epworth Sleepiness Scale (ESS) in predicting OSA among adolescents ages 11 to 19.
METHODS: The study was initiated by students from Marvin Baker Middle School in Corpus Christi, Texas and approved by the Institutional Review Board at Driscoll Children's Hospital. The study was conducted in middle and high school students in Corpus Christi, Texas. A control group of healthy student volunteers from middle and high school with Body mass index (BMI) less than 30 and a study group of adolescents with BMI ≥30 were examined. Standard Epworth tests were given and nocturnal polysomnography study was conducted for all subjects. Final Epworth scores were analyzed using Microsoft Excel Statistical package.
RESULTS: The control group had 27 subjects and the test group had 23 subjects. None of the subjects in the control group had OSA, of these, 24/27 had an ESS <10 (88.89%, P<0.05) and 3/27 had an ESS ≥10 (11.11%). Positive predictive value was 0%, and negative predictive value was 100%. In the study group, 11/23 (47.83%) subjects were diagnosed with OSA: 8 had an ESS <10 (72.73%) and 3 had an ESS ≥10 (27.27%). 12/23 had no OSA (52.17%): 9 had an ESS <10 (75%, P value <0.05) and 3 had an ESS ≥10 (25%). This gives the positive predictive value of 50%, and negative predictive value of 52.94%.
CONCLUSIONS: Among adolescents, the ESS is not a good screening test for adolescents with a BMI ≥30, whereas it can be useful in ruling out OSA among adolescents with BMI<30. Further study with a larger sample is suggested.
CLINICAL IMPLICATIONS: ESS should not be a lone screening tool for adolescents with BMI>30
DISCLOSURE: The following authors have nothing to disclose: Douglas Hagemeister, Sarita Damaraju, Aneel Damaraju, Carolyn Fan, Mathew Brehm, Sara Yu, Robert Williamson, Frances Williamson, Coleen Carrell, Mohammad Emran, Salim Surani
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