Self-evaluated and Close Relative-evaluated Epworth Sleepiness Scale vs. Multiple Sleep Latency Test

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  [Objective] The aims of this study were to 1) determine the agreements in Epworth Sleepiness Scale (ESS) evaluated by patients and their close relatives (CR); 2) The correlations of objective sleepiness as measured by Multiple Sleep Latency Test (MSLT) with self-evaluated and close relative-evaluated ESS.[Methods] A total of 85 consecutive patients with obstructive sleep apnea (OSA) (70 males, age 46.7 ± 12.9 years old) with an apnea/hypopnea index (AHI) greater than 5 events per hour (mean 38.9 ± 26.8/ hour) were recruited into this study.All participants underwent an overnight polysomnographic assessment (PSG), MSLT, and ESS rated by both patients and their CRs.Mean sleep latency of MSLT fewer than 8 min was considered objective daytime sleepiness.[Results] Self-evaluated global ESS score (ESSG) was closely correlated with that evaluated by CRs (r=0.79, P<0.001) and the mean ESSG score evaluated by patients did not significantly differ from that evaluated by CRs (P>0.05).However, Bland-Aitman plot showed that the individual differences between self-evaluated and CR-evaluated ESS score, with a 95%CI of-9.3 to 7.0.The mean sleep latency of MSLT was significantly associated with CR-evaluated ESSG (r=-0.23, P<0.05) but marginally insignificantly associated with self-evaluated ESSG (r=-0.21, P=0.05).[Conclusion] CR-evaluated ESS has a good overall correlation but also a significant individual disagreement with self-evaluated ESS in Chinese patients with OSA.CR-evaluated ESS performs as good as, if not better than, self-evaluated ESS in this population when referring to MSLT.
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