Reliability and Validity of Gujarati Version of Epworth Sleepiness Scale: A Cross-sectional Study

Abstract

Introduction: Daytime sleepiness is a common symptom of many sleep disorders. Epworth Sleepiness Scale (ESS) measures average sleep propensity of an individual for wide range of daily living activities. As it is a self-administered questionnaire, the Gujarati translation of ESS can be helpful for the evaluation of daytime sleepiness in clinical population. Aim: To find reliability and validity of Gujarati version of ESS. Materials and Methods: This cross-sectional study was conducted during August, 2020 to February, 2021. ESS is available in Gujarati language. Permission was taken to use and to find reliability and validity of Gujarati ESS from the Mapi Research Trust. This study was carried out in two phases: 1) Face and content validation by expert clinical review; 2) Test-retest reliability. The consensus method was used to find face and content validity of Gujarati ESS. The group of experts having mean experience of 10.5 years in different fields examined each item of Gujarati ESS. Each item of Gujarati ESS was scored either as rejected, accepted or accepted with modification. Procedure was continued till 80% of consensus for all items was achieved. Total 80 participants aged between 18-60 years were included in this study. To find reliability of Gujarati ESS, internal consistency and test-retest reliability was determined. The Statistical Package for Social Sciences (SPSS) version 24.0 was used to analyse the data. Test-retest reliability was determined by Intraclass Correlation Coefficient (ICC) and internal consistency was calculated by chronbach’s alpha. Results: Total of 80 participants (mean age 42.68±13.37 years; 34 males and 46 females) were studied. Normal BMI was observed for 20 participants, overweight were 26 and obese were 34. Gujarati version of ESS showed excellent test-retest reliability as evidenced by high ICC (ICC=0.94) and high Internal consistency (α=0.97). Mean score of Gujarati ESS at baseline 13±6.72 and after one week 12.98±5.65. Values for Content Validation Ratio (CVR), Item level Content Validation Index (I-CVI), Modified Kappa (K), and Proportion of agreement were 1. The content of translated items was understandable and were related to quality of sleep and its evaluation. Conclusion: Gujarati version of the ESS has excellent reliability and good face and content validity. It is adequate and useful for evaluation of day time sleepiness in Gujarati speaking population.