Assessment of Gender-Related Differences of Obstructive Sleep Apnea Measured by the Epworth Sleepiness Scale

JoAnn Turner, APRN-BC

SleepMed of South Carolina
Columbia, South Carolina

Assessment of sleepiness may provide valuable information about the health of patients.[1, 2] Numerous studies have documented that sleepiness is associated with cardiovascular disease, metabolic dysfunction, cognitive impairment, and primary sleep/wake disorders.[2, 3] Determination of a patient’s subjective sleepiness can be rapidly assessed in the primary care setting using one of a series of sleepiness questionnaires.[4] A popular patient questionnaire is the Epworth Sleepiness Scale (ESS), a short self-administered questionnaire in which the patient is asked to rate the likelihood of dozing off [5] in a series of passive situations rating each on a scale from 0 (no chance) to 3 (high chance); 8 situations are presented. A final score ≥10 is indicative of excessive sleepiness (ES) suggesting a more thorough follow-up of the patient’s sleep history. The questionnaire can also be a useful indicator of treatment progress when administered throughout the course of patient care. Many variables influence subjective sleepiness [6, 7] though the relationship to gender is less well-understood. Certainly, underlying etiologies—eg, obstructive sleep apnea (OSA), for example—are critical determinants of ES. A good sleep history tailored to the patient’s signs and symptoms can reveal levels of subjective sleepiness. A recent study conducted in part by JoAnn Turner, NP at SleepMed in Columbia, South Carolina analyzed ESS scores from patients with different sleep disorders. She observed significantly greater ESS scores in women with sleep-disordered breathing (SDB) when compared with men. Insight into the gender-related differences in sleepiness severity holds promise for improved recognition, diagnosis and treatment of patients with SDB such as OSA.[8, 9] When utilized as a red flag for potentially serious primary sleep disorders or as a surrogate marker for monitoring treatment success, patient self-reports of sleepiness can help the clinician formulate and revise a treatment plan as needed.

References

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