Answers
Andrew Schofield, Paul Schofield in The Complete SAQ Study Guide, 2019
Classically, obstructive sleep apnoea affects overweight, middle-aged men. It is often their partner that is most concerned, as they witness the apnoeic episodes. They often give a long history of snoring, but may complain of feeling increasingly tired, or falling asleep, during the day. Relaxation of the muscles responsible for maintaining the airway during sleep causes occlusion of the airway, resulting in apnoeic episodes. Each time this happens, the patient is woken from sleep due to hypoxia. This may happen hundreds of times per night, but occurs for such a short period of time they are unaware of it. The Epworth Sleepiness Scale is a questionnaire that helps determine the degree of sleepiness during the day, asking the likelihood that the patient would fall asleep in a number of everyday scenarios. Sleep studies are ultimately used to confirm the diagnosis, requiring evidence of at least 15 apnoeic/hypopnoeic episodes per hour of sleep. Simple management strategies include sleeping more upright, losing weight and avoiding alcohol/tobacco. If these fail, CPAP increases the pressure in the pharynx, helping to maintain the airway during sleep. This, however, is poorly tolerated in a number of patients.
Respiratory system
Brian J Pollard, Gareth Kitchen in Handbook of Clinical Anaesthesia, 2017
SAS is still predominantly under-recognised. Look for a history of snoring, daytime sleepiness or lethargy and witnessed apnoeas. Identify other features such as depression, neurocognitive or functional decline. Seek a corroborative history from a partner, as patients will often deny symptoms due to insidious onset or being unaware of their own sleep disturbance. Identify comorbidities (e.g. hypertension, diabetes mellitus) and risks (skilled mechanical work, HGV driving, pilots, etc.). The Epworth sleepiness scale is a self-reported indicator of sleepiness, when other confounders to adequate sleep are excluded (e.g. prostate problems, symptomatic nocturnal acid reflux, noise or light disturbance). It has 8 questions of different situations each with a weighted scale of 0–3 of likelihood of dozing off. A score >10/24 indicates a pathological reason for excessive sleepiness. However, it does not correlate well with severity of SAS. Other questionnaires have been validated in different settings such as the Berlin and STOPBANG scoring models.
Managing Fatigue in Adults After Acquired Brain Injury
Barbara A. Wilson, Jill Winegardner, Caroline M. van Heugten, Tamara Ownsworth in Neuropsychological Rehabilitation, 2017
Sleepiness during the day may be reported by people following an ABI alongside fatigue, but they do not always co-exist and are therefore considered as separate constructs (Cantor et al., 2012). Clearly disrupted sleep will exacerbate fatigue and contribute to tiredness during the day, and disrupted sleep patterns are common following ABI. Sleep disorders may be a result of an ABI or a premorbid difficulty and therefore warrant medical attention in their own right. It has been estimated that around 46 per cent of people experience sleep disorders after TBI (Castriotta and Murthy, 2011). Scales such as the Epworth Sleepiness Scale (Johns, 1991) and the Pittsburgh Sleep Quality Index (Buysse et al., 1989) can be used as screening tools to indicate need for referral to a physician for further investigation, once sleep hygiene measures have been attempted. People may nap during the day to alleviate ‘fatigue’ but this is not always successful and can disrupt circadian rhythms if naps are taken late in the day or for long periods of time. Sleep hygiene techniques and CBT can be effective to improve quality of sleep (Ponsford et al., 2012).
Physical activity and sleep quality correlations with anthropometric measurements in young adults
Published in Journal of American College Health, 2023
Ashley Y. Kim, John H. Gieng, Shiho Osako Luna, Kasuen Mauldin
The Epworth Sleepiness Scale is a validated, self-rated questionnaire that evaluates participant daytime sleepiness.35 There are eight questions, with a range of 0–3 for each question to provide a total Epworth Sleepiness Scale score range between 0–24. A total score >10 indicates significant daytime sleepiness.35 Participants completing the survey are asked how likely they are to fall asleep in situations such as sitting and reading or as a passenger in the car for an hour without a break.27 Psychometric analyses of the Epworth Sleepiness Scale questionnaire has confirmed its validity and reliability,39–41 and a Cronbach’s alpha of 0.70 has been reported for the Epworth Sleepiness Scale questionnaire.38 The Epworth Sleepiness Scale questionnaire has been widely used in research and has been translated into 52 languages.35
Comparison of clinical and polysomnographic characteristics in young and old patients with obstructive sleep apnea syndrome
Published in The Aging Male, 2020
Hakan Celikhisar, Gulay Dasdemir Ilkhan
All patients included in the study were followed-up at night in our sleep center with PSG device and at least 6 h of PSG records were obtained. PSG was performed according to the American Academy of Sleep Disorders criteria [1]. Patients who needed PAP treatment were hospitalized for a second time and PAP titration was performed. Daytime sleepiness was evaluated according to the Epworth sleepiness scale. In addition to clinical features of all patients such as insomnia, tired awakening, non-concentration, personality changes, motor activity, nocturia, enuresis, gastroesophageal reflux symptoms; PSG values such as mean desaturation index, minimum oxygen saturation, mean oxygen saturation, sleep latency, sleep efficiency, total sleep time, REM%, NREM 1, 2, 3%, mean apnea time, arousal index, mean PAP values, and PAP usage compliance were recorded. On the other hand, patients under PAP treatment were evaluated for compatibility based on PAP software data. For more than 4 h/night and for at least 4 days/week use was accepted as compliance [7]. Demographic, clinical and polysomnographic variables of patients, as well as the device use compliance of the patients 65 years and older and younger, were compared (Table 2).
Accumulation of sleep loss among shift-working truck drivers
Published in Chronobiology International, 2021
Jussi Onninen, Mia Pylkkönen, Asko Tolvanen, Mikael Sallinen
Data regarding sleep habits were collected using the Diurnal Type Questionnaire (DTQ) (Torsvall and Åkerstedt 1980) and a sleep questionnaire developed by the FIOH. The latter included the Epworth Sleepiness Scale (ESS) (Johns 1991). Based on the DTQ, the drivers were classified as morning, intermediate (neither morning nor evening), or evening types. Individual daily sleep need was self-reported using the following item of the questionnaire: “How many hours of sleep do you need per 24 hours (how many hours would you sleep if you could sleep as long as you want)? In other words, how much sleep do you need to be alert and fit for duty the next day?” For drivers who gave minimum and maximum values instead of one value (n = 4), the mean of these values was used as their individual daily sleep need. A detailed description of the study design is presented in Pylkkönen et al. (2015).
Related Knowledge Centers
- Excessive Daytime Sleepiness
- Likert Scale
- Sensitivity & Specificity
- Sleep
- Sleep Apnea
- Sleep Disorder
- Narcolepsy
- Validity
- Idiopathic Hypersomnia
- Positive Airway Pressure
- Sensitivity & Specificity