Use of the Epworth Sleepiness Scale to evaluate the symptom of excessive sleepiness in major depressive disorder (original) (raw)

Depressive symptoms and sleep: A population-based polysomnographic study

Psychiatry Research, 2013

The goals of the present study were to determine the prevalence of depression in the adult population of Sao Paulo, Brazil and to explore the relationship among sociodemographic, physical and psychological factors, sleep-related symptoms and polysomnography parameters. Participants of a cross-sectional study (N ¼1101) were administered questionnaires and submitted to polysomnography. A score 420 in the Beck Depression Inventory was used to describe depression. Results revealed that the prevalence of depression was 10.9%. Estimates were higher in women and were significantly higher among housewives, non-workers and individuals with lower education and income. A combination of sleep-related symptoms and impaired quality of life was 2.5 times more frequent among depressed than nondepressed. Co-morbid insomnia and anxiety were positively associated to depressive symptomatology. There were no alterations in the polysomnography parameters, in either group. The occurrence of sleep apnea with values on the apnea-hypopnea index Z5 was similar and frequent in both groups (around 30%). The findings suggest that depressive symptoms were associated with low education, low income, severe comorbid symptomatology, and impaired quality of life. Considering the high prevalence of sleep apnea, these results point to potential social and financial burdens associated with the depressive symptomatology and various sleep diagnoses.

Comparative levels of excessive daytime sleepiness in common medical disorders

Sleep Medicine, 2010

Introduction-Sleep restriction and sleep disorders are common causes of excessive daytime sleepiness (EDS). Medical disorders (MD) can also cause EDS, but previous studies have used nonstandardized measures, selected samples, or have examined EDS in singular disorders. This study describes the relative degree of EDS associated with medical disorders to provide comparative data across a range of common medical conditions in a large unselected community-based sample.

Excessive daytime sleepiness in depressed women

Psychiatry Research, 2010

Excessive daytime sleepiness (EDS) is a symptom with high public health importance. Within psychiatric settings, depression is the most significant risk factor for EDS; however, this relationship has not been clearly detailed. The aim of this study was to describe the quality of sleep of depressed patients with and without EDS and to investigate the association between EDS and depression severity. A cross-sectional study with 78 female depressed outpatients (34.17±11.37 years; range 18-60) was performed. The Epworth Sleepiness Scale, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index, and the Hamilton Rating Scale for Depression (HRSD) were administered. Patients were classified in two groups: with (43.5%) and without (56.5%) EDS. There were no differences with regard to comorbidity, socio-demographic (except for employment), or HRSD variables. The two groups were homogeneous in sleep patterns, with no difference in quality or sleep efficiency. EDS was not associated with reduced sleep efficiency or severity of depressive symptoms. Limitations of the present study include the small sample size and the use of self-report measurements. These results offer valuable information to clinicians in the sense of the need to deeply investigate the etiology of EDS before attributing it to bad sleep quality or depression severity.

Excessive daytime sleepiness in patients with depressive disorder

Revista Brasileira de Psiquiatria, 2006

Excessive daytime sleepiness in patients with depressive disorder Sonolência diurna excessiva em pacientes com transtorno depressivo A b s t r a c t Objective: To evaluate excessive daytime sleepiness in patients with depressive disorder and to examine its association with the severity of depression and suicidal ideation. Method: Seventy patients were interviewed and assessed by the Epworth Sleepiness Scale (ESS), the Beck Depression Inventory (BDI) and the Beck Scale for Suicidal Ideation (SSI). Descriptive analysis, Pearson correlations and Student's t-test were used for data analyses. Results: Most of the patients (57.1%) obtained high scores on the ESS. Correlation was positive and strongly significant between ESS scores and BDI scores, as well as between ESS scores and SSI scores. Patients with high ESS scores obtained higher mean BDI and SSI scores in comparison to patients with lower ESS scores. Significant differences (p < 0.05) were encountered when the patients with higher (>10) and lower (< 10) ESS scores were compared in terms of total ESS, BDI and SSI scores. Conclusions: Excessive daytime sleepiness was frequent among patients and significantly associated with higher levels of depression and particularly with suicidal ideation. Thus, a careful investigation of daytime sleepiness in depressed patients is required during clinical evaluation. Resumo Objetivo: Avaliar a incidência de sonolência diurna excessiva em pacientes com transtorno depressivo e examinar sua associação com a gravidade do quadro depressivo e ideação suicida. Método: Setenta pacientes foram entrevistados e avaliados através da . Análises descritivas, análise de correlação de Pearson e teste-t de Student foram utilizados para a análise dos dados. Resultados: A maioria dos paciente (57,1%) apresentaram altas pontuações na ESE. Houve correlações positivas e fortes entre scores da ESE e BD e entre scores da ESE e EIS. Pacientes com altas pontuações na ESE obtiveram escores na BD e na EIS mais elevados do que os pacientes com baixos escores de ESE. Houve diferenças significativas (p < 0,05) entre pacientes com escores mais baixos (< 10) e mais elevados (> 10) na ESE, em relação às pontuações totais das ESE, EDB e EIS. Conclusões: A sonolência diurna excessiva foi freqüente nos pacientes e significativamente associada a maior gravidade da depressão e ideação suicida. Desta maneira, é necessária uma cuidadosa investigação da sonolência diurna excessiva em pacientes deprimidos durante a avaliação clínica. Descritores: Transtornos do sono; Distúrbios do sono por sonolência excessiva; Transtorno depressivo; Inventário de personalidade; Suicídio/psicologia Rev Bras Psiquiatr. 2006;28(2):126-9

Wanted: a better cut-off value for the Epworth Sleepiness Scale

Wiener klinische Wochenschrift, 2018

Excessive daytime sleepiness (EDS) is the main complaint in many neurological sleep disorders, such as idiopathic hypersomnia, narcolepsy, or obstructive sleep apnea/hypopnea syndrome (OSAS). The validity of the Epworth Sleepiness Scale (ESS) as a screening tool for EDS remains controversial. We therefore investigated (1) the interrelation of the ESS total score and the mean sleep latency (MSL) during the multiple sleep latency test (MSLT) and (2) the diagnostic accuracy of the ESS total score to detect EDS in patients with the chief complaint of subjective EDS. A total of 94 patients (48 males) with subjective EDS were included in this study. Regression analyses and ROC curve analyses were carried out to assess the predictive value of the ESS score for MSL. The ESS score significantly predicted a shortened MSL (p = 0.01, β = -0.29). After dichotomizing into two groups, the ESS score predicted MSL only in patients with hypersomnia or narcolepsy (p = 0.01, β = -0.33), but not in pati...

Sleep disturbances and depression

Sleep disturbances are frequently a symptom of depression. Patients with mood disorders were found to have more robust changes across more sleep parameters than did patients with other disorders or healthy controls. The association between depression and disturbed sleep has been well documented in both clinical and epidemiologic studies. Adequately addressing sleep disturbance is particular relevant for these patients, as there is some evidence that the presence of sleep complaint is associated with greater severity of patient’s primary condition. There is both objective and subjective evidence that sleep is disturbed in depressed patients. Subjective assessments of sleep in patients with depression tend to confirm objective measures (polysomnographic recordings). Interesting findings derive from the study of sleep microstructure and in particular Cyclic Alternating Pattern (CAP). It’s also important to consider that many medications used to treat depression may disturb sleep. Given a clear association between sleep disturbances and depression, a number of important clinical issues remain to be elucidated in order to improve diagnosis, allow for better treatment decisions and aid in the development of new therapies.

Normative values of the Epworth Sleepiness Scale (ESS), derived from a large German sample

Sleep and Breathing, 2016

Purpose Daytime sleepiness is associated with several medical problems. The aim of this paper is to provide normative values for one of the most often used questionnaires measuring daytime sleepiness, the Epworth Sleepiness Scale (ESS). Methods A large sample of 9711 people from the German general population took part in this study. In addition to the ESS, several other questionnaires were used, and sociodemographic and behavioral factors were recorded. Results Normative values for the ESS are given. According to the generally accepted criterion ESS > 10, 23 % of the sample showed excessive daytime sleepiness. Males reported significantly more daytime sleepiness than females (effect size d = 0.19). In the age range of 40-80 years, a continuous decline of daytime sleepiness was observed. Psychometric properties of the ESS were good. Alcohol intake and nicotine consumption were marginally associated with daytime sleepiness, and obese people reported significantly more sleepiness than people of normal weight (OR = 1.39). Conclusions The normative tables allow clinicians and researchers to assess the degree of their patients' daytime sleepiness, especially in the upper range of scores.