Excessive daytime sleepiness assessed by the Epworth Sleepiness Scale and its association with health related quality of life: a population-based study in China

Shunquan Wu,Rui Wang,Xiuqiang Ma,Jia He,Yanfang Zhao,Xiaoyan Yan

doi:10.1186/1471-2458-12-849

Abstract

BackgroundExcessive daytime sleepiness (EDS) is a common condition worldwide that has many negative effects on people who were afflicted with it, especially on their health-related quality of life (HRQOL). The Epworth Sleepiness Scale (ESS) is a commonly used method for evaluating EDS in English-speaking countries. This paper reported the prevalence of subjective EDS in China as assessed by the Mandarin version of the ESS; tested the scale’s response rate, reliability and validity; and investigated the relationship between ESS scores and HRQOL.MethodsA population-based sample of 3600 residents was selected randomly in five cities in China. The demographic information was collected, subjective EDS was assessed by the Mandarin version of the ESS (ESS scores >10), and HRQOL was evaluated by the Mandarin version of the 36-item Short Form Health Survey (SF-36).ResultsThe Mandarin version of ESS had very few missing responses, and the average response rate of its eight items was 97.92%. The split-half reliability coefficient and Cronbach’s α coefficient were 0.81 and 0.80, respectively. One factor was identified by factor analysis with an eigenvalue of 2.78. The ESS scores showed positive skewness in the selected sample, with a median (Q1, Q3) of 6 (3, 0). 644 (22.16%) respondents reported subjective EDS, and all of the scores of the eight dimensions of the SF-36 were negatively correlated with ESS scores.ConclusionsThe Mandarin version of ESS is an acceptable, reliable, and valid tool for measuring EDS. In addition, subjective EDS is common in China, based on the ESS results, and impairs HRQOL.

Highlights

Excessive daytime sleepiness (EDS) is a common condition worldwide that has many negative effects on people who were afflicted with it, especially on their health-related quality of life (HRQOL)
After further consideration of the sociodemographic variables, including region, gender, age, education, occupation, BMI, and prevalence of chronic diseases, using multiple linear regression analysis, we found that the scores of the physical functioning (PF), RP, bodily pain (BP), general health perception (GH), VT, social functioning (SF), RE, and mental health (MH) scales were still significantly negatively correlated with Epworth Sleepiness Scale (ESS) scores (p < 0.001), with the standard regression coefficients being −0.13, -0.12, -0.13, -0.24, -0.25, -0.16, -0.13, and −0.22, respectively
Our study reported the response rate, reliability, and validity of the Mandarin version of the ESS when applying it to the general population in five cities of China

Summary

Introduction

Excessive daytime sleepiness (EDS) is a common condition worldwide that has many negative effects on people who were afflicted with it, especially on their health-related quality of life (HRQOL). Excessive daytime sleepiness (EDS) is a public health concern. It can be caused by disorders such as obstructive sleep apnea (OSA), narcolepsy, and idiopathic hypersomnia [1,2,3,4]. EDS might be associated with impaired health-related quality of life (HRQOL) in patients with OSA [7] and narcolepsy [8,9,10,11]. Briones et al found that EDS had an important impact on general health and functional status, which they interpreted as reflecting HRQOL, as measured by the Medical Outcomes Study Short Form 36 [12]. Similar results were obtained in another study [13]

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