Validación de la versión española del test de somnolencia Epworth en pacientes con síndrome de apnea de sueñoValidation of the Spanish versión of the Epworth Sieepiness Scale in patients with sieep apnea syndrome

https://doi.org/10.1016/S0300-2896(15)30037-5Get rights and content

Se obtuvo una versión española del test de somnolencia Epworth (ESS) mediante el método de traducción, retrotraducción, discusión formal y reunión de investigadores con un grupo de pacientes con síndrome de apnea de sueño (SAS). El cuestionario definitivo fue testado en 345 pacientes, 275 afectados de SAS con diferentes grados de severidad y 70 sin SAS. Existieron diferencias significativas entre ambos grupos en la edad (53 ±11 frente a 47 ± 13 años, p < 0,001) y el índice de masa corporal (IMC) (32 ± 5 frente a 29,5 ± 5, p < 0,001). Los pacientes con SAS presentaron puntuaciones significativamente más altas (14 ± 5) respecto a los pacientes sin SAS (10 ± 5) (p < 0,001). La reproducibilidad se testó en 146 pacientes (113 SAS y 33 no SAS), no observando diferencias significativas en los pacientes con SAS (14,9 ± 5 frente a 14,2 ± 5, p = NS) aunque sí en los 33 pacientes sin SAS (12 ± 5 frente a 10 ± 5, p < 0,01). Se obtuvieron correlaciones significativas tanto en la puntuación total como en cada ítem en ambos grupos. Asimismo, cada ítem se correlacionó con la puntuación total en pacientes con SAS. La sensibilidad a los cambios postratamiento fue evaluada en 77 pacientes con SAS. La puntuación inicial de 16 ± 4 disminuyó a 4 ± 3 tras tratamiento con presión positiva continua (CPAP). Se observó un ESS > 10 en el 85% de pacientes con SAS, en el 78% del grado leve, en el 85% del moderado y en el 92% del severo. Se observaron diferencias significativas entre grupos al aplicar el análisis de la variancia (p < 0,001), y fueron asimismo significativas las comparaciones múltiples, con grados más altos al aumentar la severidad. Los pacientes con SAS y grado de ESS1 < 10 presentaron un índice de apnea-hipopnea (IAH) menor (35 ± 18 frente a 42 ± 20, p < 0,005), menor índice de desaturación (21 ± 21 frente a 34 ± 28, p < 0,01) y mayor saturación mínima (80 ± 10 frente a 75 ± 12, p < 0,05), sin observarse diferencias en la edad ni en el IMC. Se obtuvo una correlación significativa entre el ESS y las variables respiratorias de la polisomnografía: IAH (r = 0,23, p < 0,001), porcentaje de tiempo en apnea-hipopnea (r = 0,18, p < 0,01), índice de desaturaciones (r = 0,27, p < 0,01) y saturación mínima (r = 0,14, p < 0,05). Concluimos que la versión española del ESS es equivalente a la versión original, es reprodutible en pacientes con SAS, sensible a los cambios postratamiento y parece discriminar el grado de severidad presentando una correlación significativa con las variables obtenidas en la polisomnografía.

A Spanish version of the Epworth Sleepiness Scale (ESS-Sp) was developed by translation, back-translation, formal discussion, and a meeting of researchers with a group of patients with sleep apnea syndrome (SAS). The translated questionnaire was then tested in 345 patients, 275 with SAS at various levels of severity and 70 without SAS. Significant differences existed between the two groups as to age (53 ±11 years versus 47 ± 13, p < 0.001) and BMI (32 ± 5 versus 29.5 ± 5, p < 0.001). Patients with SAS had significantly higher scores (14 ± 5) than did those without SAS (10 ± 5) (p < 0.001). Reproducibility was tested in 146 patients (113 SAS and 33 non-SAS), with no significant differences found among patients with SAS (14.9 ± 5 versus 14.2 ± 5, p = n.s.); significant differences in BMI were found, however, among the 33 non-SAS patients (12 ± 5 versus 10 ± 5, p < 0.01). Total scores and individual item scores were related in both groups. Likewise, each item was related to total score in patients with SAS. Sensitivity to post-treatment changes was assessed in 77 SAS patients, with initial scores of 16 ± 4 seen to decrease to 4 ± 3 after continuous positive airway pressure. ESS-Sp scores over 10 were recorded for 85% of patients with SAS: 78% of those with mild SAS, 85% of those with modérate disease and 92% of those whose SAS was severe. Significant inter-group differences were found upon applying a test of variance (p < 0.001). Differences continued to be detected when multiple correlations were looked for, with differences increasing with severity. SAS patients with ESS-Sp level one scores ( < 10) had lower apnea-hypopnea indices (AHI) (35 ± 18 versus 42 ± 20, p < 0.05), lower desaturation levels (21 ± 21 versus 34 ± 28, p < 0.01) and higher minimum saturation (80 ± 10 versus 75 ± 12, p < 0.05), with no differences in age or BMI. A significant correlation was found between ESS-Sp score and respiratory variables recorded during polysomnography: AHI, r = 0.23 (p < 0.001); percent time in apnea-hypopnea, r = 0.18 (p < 0.01); desaturation index, r = 0.27 (p < 0.01) and mínimum saturation (r = 0.14, p < 0.05). We conclude that the Spanish version of the ESS is equivalent to the original, is reproducible in patients with SAS, sensitive to post-treatment changes and seems to discriminate level of severity, showing correlation with polysomnograph variables.

Bibliografía (23)

  • M.W. Johns

    Reliability and factor analysis of the Epworth Sleepiness Scale

    Sleep

    (1992)
  • Cited by (197)

    • Assessment of Vigilance and Fatigue

      2023, Sleep Medicine Clinics
    • Association between sleep-disordered breathing and prostate cancer

      2022, Sleep Medicine
      Citation Excerpt :

      The men then attended the sleep-disordered breathing unit, where they were interviewed by a sleep physician, who collected clinical information in accordance with a standardized protocol, and subsequently underwent a sleep test. The protocol included general and anthropometric data, physical activity, subjective sleep duration, night-shift work for more than 1 year, and subjective sleepiness measured by the Epworth Sleepiness Scale (ESS) [15]. Every man underwent a home respiratory polygraphy (HRP) using a device validated against polysomnography, following the Spanish Society of Pneumology and Thoracic Surgery Guidelines for SDB diagnosis and treatment [16].

    • Impact of Obstructive Sleep Apnea on Gestational Diabetes Mellitus

      2022, Archivos de Bronconeumologia
      Citation Excerpt :

      Laboratory researchers and study personnel were blinded to maternal status. Anthropometric, clinical, and sleep data, including Epworth Sleepiness Scale (ESS),23 were collected in all participants. Attended PSG was performed and manually scored using conventional criteria in each center.24,25

    View all citing articles on Scopus
    View full text