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Is The Epworth Sleepiness Scale A Reliable Indicator of Sleep Apnea. For Everyone?

The Epworth Sleepiness Scale is used as a quantifying the level of daytime sleepiness in specific situations. I would like to ask the sleep professionals on Sleep Guide how they rate this scale. I ask because my answers to the scale delayed my diagnosis of sleep apnea.

My internist was a good diagnostician; he apparently suspected I had sleep apnea because at each visit he presented me with the Epworth Sleepiness Scale, asking me to complete it. My answers, all in the negative - I never had the slightest risk of falling asleep, at any place in the daytime. I didn't do much better at night either. Eventually he firmly suggested a sleep study. I didn't comply right away, but completed the Polysomnography in 2000.

The doctor was right when he thought I might have sleep apnea. I was diagnosed with severe Obstructive Sleep Apnea Syndrome with almost 100 apneas and hypopenas per hour of sleep accompanied by moderate to severe oxygen desaturations. A titration study was ordered. In the Study Summary, the comment was included "Nevertheless, she has a low Epworth scale score, of 1 out of a possible 24, indicating a low degree of daytime somnolence"

Some of my earliest childhood memories including laying awake for a long time at night. By teen age and adulthood I experienced chronic insonmia - perhaps partly because I was a curious and didn't want to miss having a part in anything interesting.

Cpap mask had not reached their current technicological level, and I could not get a mask that didn't blow directly into my eyes. I eventually had UPPP surgery. I have had subsequent sleep studies indicating moderate sleep apnea. I bepan CPAP therapy in January 2009..

I had experienced insonmia, or an unwillingness to go to sleep till starting CPAP, My Epworth Sleepiness Scale also changed after starting CPAP. I fell asleep in plays, at church, in a doctor's office; almost anyplace I sat down. I was sleep deprived at that time, and attributed my daytime sleepiness to lack of sleep. I am not sleep deprived now, but I have frequently have to fight falling asleep in the daytime. I estimate my currnent Epworth Sleepiness Scale would be around 14.

Can a sleep technician tell if a person's body chemistry changes during CPAP - or what could have created such a drastic change? Have others had a change in their daytime sleepiness. I am puzzled, and would like to understand the intricities of sleep, and why they can change later in life.






person and didn't want to miss being a part of anything interesting.

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Good discussion going on.Epworth sleepiness scale must be critically examined.Sleep apnea is never to be taken lightly.
As previously said it is JUST A TOOL. As such it has MANY weaknesses and its greatest fault/weakness is that too many doctors rely totally on it instead of LISTENING to and HEEDING their patients!!

I've run into this consistently w/the CDAI (Crohn's disease activity index). I'm fortunate to have a fairly mild case of Crohn's disease. I was Dx'd at the LEADING GASTROENTEROLOGY DEPARTMENT IN THE USA, Mayo Clinic, Rochester, MN. I had my emergency resection there 2 years later. I barely fit the CDAI at that time. I then enjoyed a 20 year remission. When it activated again, my family doctor had died and I was doctor shopping, the smirks I got when I said my Crohn's was active again were infuriating. I didn't fit the CDAI at all this time. The CDAI is a RESEARCH TOOL, the leading IBD researchers clearly recognize and state that its value is FOR RESEARCH ONLY. The CDAI catches some of the moderate cases of Crohn's and most of the severe cases which are THE cases best used for clinical trials. As w/the Epworth for OSA, if you don't have the "classic" (read that obvious) symptoms it is meaningless.

I raised and showed dogs for some 30 years. One thing I learned fairly early on: the GOOD vets were the ones who relied on instinct and education as well as their precious tests. If the symptoms said one thing but the tests said not likely, they initiated treatment according to symptoms on a trial basis.

Radiology films are only as good as the tech doing them and the radiologist reading them. Lab tests are only as good as the tech doing them and doing the interpretation/reading, etc., etc. I found this holds true in human medicine as well. I've had a test run locally interpreted as negative for Crohn's and less than a month later had the exact same test run at Mayo Clinic clearly showing Crohn's activity, etc., etc.
Great comparison Judy - If we are lucky to keep an doctor over a period of time, I think they begin to know us well enough that their intuitive sense helps guide them to the necessary diagnosis and treatment for whatever problems we have at the moment. Ruth

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