Sleep Medicine
Volume 7, Issue 4 , Pages 327-332, June 2006

The Epworth sleepiness scale: relationship to sleep and mental disorders in a sleep clinic

  • Kent J. DeZee

      Affiliations

    • Department of Medicine, William Beaumont Army Medical Center, 5005 N. Piedras Street, El Paso, TX 79920-5001, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 915 569 2180; fax: +1 915 569 1919.
    • ,
  • Jeffrey L. Jackson

      Affiliations

    • Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
    • ,
  • Christos Hatzigeorgiou

      Affiliations

    • Department of Medicine, Tripler Army Medical Center, 1 Jarrett White Road, Tripler, HI 96859, USA
    • ,
  • David Kristo

      Affiliations

    • Department of Pulmonary Medicine, Walter Reed Army Medical Center, 6900 Georgia Avenue, Washington, DC 20307, USA

Received 3 June 2005; received in revised form 31 October 2005; accepted 5 November 2005.

Abstract 

Background and purpose

Both sleep disorders and mental disorders are associated with excessive daytime sleepiness as measured by the Epworth sleepiness scale (ESS). We sought to assess the relationship between the ESS scores and mental disorders in a sleep clinic.

Methods

One hundred sixty-five consecutive new referrals to a sleep clinic completed the ESS prior to their initial visit. Mental disorders (major depression, minor depression, anxiety not otherwise specified, and panic disorder) were diagnosed with the primary care evaluation of mental disorders (PRIME-MD) questionnaire, a reliable and valid instrument. Nearly all sleep diagnoses (95%) were made by polysomnography.

Results

The mean ESS for the cohort was 12.3 (standard deviation (SD) 5.1). There was no difference in the mean ESS for those with and without mental disorders (12.8 vs. 12.2, P=0.48) or sleep-disordered breathing (SDB) (12.3 vs. 12.3, P=0.99). ESS scores were not different between patients with a comorbid mental disorder and SDB compared with the presence of a mental disorder or SDB alone (combination: 13.0 vs. mental disorder: 11.5 vs. SDB: 12.2, P=0.70). There was also no relationship between ESS scores and the respiratory disturbance index (RDI) (P=0.63).

Conclusions

We found no relationship between ESS scores and mental disorders among referrals to a sleep clinic. ESS cannot be used to screen for mental disorders among sleep clinic patients.

Keywords: Mental disorders, Depression, Sleep apnea syndromes, Epworth sleepiness scale, Sleep disorders

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PII: S1389-9457(05)00266-2

doi:10.1016/j.sleep.2005.11.001

Sleep Medicine
Volume 7, Issue 4 , Pages 327-332, June 2006

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