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Sleep Disorders |

Development and Validation of a New Scale for Evaluation of Excessive Sleepiness

Uma maheswari Krishnaswamy, MD; Ragashree Kadur, MBBS; Aayushman Misra, MD; Anshum Aneja, DTCD; Kevin Dsouza; Kadambari Vijaykumar
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Respiratory Medicine, M.S. Ramaiah Medical College and Hospitals, Bangalore, Karnataka, India


Chest. 2014;146(4_MeetingAbstracts):933A. doi:10.1378/chest.1987700
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Abstract

SESSION TITLE: Sleep Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: The Epworth Sleepiness Scale (ESS) is the one of the most widely used tools to screen for sleepiness. Some limitations of ESS are that most situations are passive, responses are graded and equal weightage is given to active and passive situations. In order to overcome these limitations, a sleepiness scale (Indian Sleepiness Scale; ISS) was developed and validated and copyrighted in our institution. This scale is easy to administer (yes/no responses), consists of multiple active situations and weighted scores are assigned to each question after administration. In the present study, the ISS and ESS were compared in patients with obstructive sleep apnea (OSA).

METHODS: The ISS and the ESS were administered to consecutive patients with suspected OSA attending Sleep Clinic. Polysomnography (PSG) was performed in patients with intrusive snoring with excessive daytime sleepiness and /or ESS score of >10. Patients were classified as mild, moderate and severe OSA based on AHI. The ESS and ISS scores were compared in patients with confirmed OSA.

RESULTS: Out of 58 patients who underwent PSG for suspected OSA, 52 (89.6%) patients were confirmed to have OSA. All questions in ESS were answered by only twenty two (37.9%) patients; the remaining could not answer one or more items as the situations described were inapplicable to them. However, 30 (57.1%) patients were able to respond to all items in the new questionnaire. The sensitivity and specificity of ESS were 57.6% and 33% at the accepted cut-off value. A cut off value of ≥7 was arrived at for the ISS based on an ROC curve. The sensitivity and specificity of ISS at this cut-off were 84.6% and 50% respectively.

CONCLUSIONS: The ISS was proven to be more applicable, sensitive and specific compared to the ESS in patients with suspected OSA.

CLINICAL IMPLICATIONS: The Indian Sleepiness Scale described in this study is a simple screening tool which overcomes many limitations of the ESS. Thus, it and can be used as a stand-alone or add-on tool to achieve better quantification of sleepiness.

DISCLOSURE: The following authors have nothing to disclose: Uma maheswari Krishnaswamy, Ragashree Kadur, Aayushman Misra, Anshum Aneja, Kevin Dsouza, Kadambari Vijaykumar

No Product/Research Disclosure Information


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