The influence of age, gender, ethnicity, and insomnia on Epworth sleepiness scores: A normative US population

Sanford, Stacy D.; Lichstein, Kenneth L.; Durrence, H. Heith; Riedel, Brant W.; Taylor, Daniel J.; Bush, Andrew J.

doi:10.1016/j.sleep.2006.01.010

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Volume 7, Issue 4 , Pages 319-326, June 2006

The influence of age, gender, ethnicity, and insomnia on Epworth sleepiness scores: A normative US population

Department of Psychology, University of Alabama, 348 Gordon Palmer Hall, Tuscaloosa, AL 35487, USA

Received 10 September 2005; received in revised form 10 November 2005; accepted 21 January 2006.

Abstract

Background and purpose

This study explored the distribution of Epworth Sleepiness Scale (ESS) scores in a randomly sampled, community population and provided percentile scores that will assist in decision-making in both research and clinical settings.

Patients and methods

Participants included 703 individuals between the ages of 20 and 98, with 116 people with insomnia (PWI) and 587 people not having insomnia (PNI). Analyses produced main effects for sleep status and ethnicity.

Results

PWI had higher ESS scores than PNI and African–Americans had higher ESS scores than Caucasians, although effect sizes were small. Gender, age group, and season did not impact ESS scores. Receiver operating characteristic (ROC) curve analysis proved the ESS to discriminate poorly between PWI and PNI.

Conclusions

This study found higher percentages of ‘sleepy’ individuals than previous studies. PWI did have slightly elevated scores on the ESS, but this elevation was not necessarily predictive of an insomnia diagnosis. Results support a continuum of sleepiness/alertness among PWI.

Keywords: Epworth sleepiness scale, Ethnicity, Insomnia, Gender, Age, Season, Normative data