There have been few studies comparing ESS in males and females with severities of OSA. The ESS is a commonly used scale measuring excessive daytime sleepiness (EDS). The aim of this study is to measure gender-related differences in subjects with mild, moderate and severe OSA presenting to a sleep clinic with a sleep complaint.
Retrospective evaluation of subjects over 15 years of age was performed. All were referred to a SleepMed site in 2008. ESS was administered prior to baseline PSG and four groups were analyzed based on the respiratory disturbance index (RDI): no OSA (RDI < 5); mild OSA (RDI 5–15), moderate OSA (RDI 16–30) and severe OSA (RDI > 30). The ESS scores were then compared by gender in each OSA group.
In 29777 subjects, 50% males and 50% females: 17%= no OSA, 36%= mild OSA, 24%= moderate OSA and 22%= severe OSA. Mean RDI in females= 17(18)/ males= 27(24) (p < 0.001). Other means are reported: age male= 51(15) years/ female 52(15); and BMI men = 31(7), women = 34 (10) and both sexes ESS score=10(6). ESS scores were analyzed and the groups with significant gender differences were: no OSA with a mean score =9.9(33) in females and in males = 9.2(33)/p = 6.97 E-05; and in the mild OSA with a mean score =10.1(30) in females and=9.8(29) in males/ p = 0.0001. Moderate OSA had mean scores in both genders= 10(29) while in severe OSA scores= 11(32) in both without statistical difference.
Not all patients with OSA are sleepy. Our results show that individuals presenting to our clinic had overall mean score of 10 with a broad range in scores. ESS scores did not have any statistical gender difference in moderate to severe OSA even though overall OSA severity is greater in men. For groups with no OSA or mild OSA, results indicate different subjective perception of EDS with females reporting higher ESS scores.
Opportunities to share clinical experience with this tool in large populations can provide new insights into OSA disease states.
Jo Anne Turner, No Financial Disclosure Information; No Product/Research Disclosure Information