Epworth Sleepiness Scale outcome in 616 brazilian medical students

Alóe, Flávio; Pedroso, André; Tavares, Stella Márcia

doi:10.1590/S0004-282X1997000200009

Abstracts

The Epworth Sleepiness Scale (ESS) measures daytime sleepiness in adults. This paper reports the following data in 616 medical students: 1 -ESS scores, 2-its correlation with the declared night sleep time, 3-comparison with ESS values obtained from Australia, 4-comparison of ESS values in a sub-population of 111 students tested early and late 1995. There were 387 males, 185 females and 4 not specified. Age = 20.16±2.23 (SD). ESS score = 10.00 ± 3.69 (SD), declared sleep time = 7.04± 1.03 (SD). ESS scores did not statistically correlate with sleep time. Average ESS score was statistically higher than in the Australian sample. Retesting of the medical students showed an increase in ESS values from March to November 1995. Sleep time difference was non-significant. Higher ESS scores in this sample seem to be related to shorter sleep time, but fatigue effects can not be ruled out.

sleepiness; nighttime sleep; medical students; Epworth; questionnaire

A Escala de Sonolência de Epworth (ESE) mede sonolência diurna em adultos. Este estudo relata os seguintes dados de 616 alunos de medicina da Faculdade de Medicina da Universidade de São Paulo: 1- média de ESE, 2- sua correlação com o número de horas de sono, 3- comparação com a média obtida na Austrália, 4- comparação dos valores de 111 alunos testados no início e no final de 1995. Valor médio da ESE = 10,00±3,69 (DP). Horas de sono = 7,04± 1,03 (DP). Os valores de ESE não se correlacionaram estatisticamente com o tempo de sono. A média da ESE foi estatisticamente maior que na amostra australiana. O reteste mostrou aumento nos valores da ESE de março a novembro de 1995, sem diferença estatística no número de horas de sono. Os valores mais altos da ESE nesta população parecem estar relacionados com sono mais curto mas os efeitos da fadiga não podem ser afastados.

sonolência; sono noturno; estudantes de medicina; Epworth; questionário

Epworth Sleepiness Scale outcome in 616 brazilian medical students

Desempenho na Escala de Sonolência de Epworth de 616 estudantes de medicina brasileiros

Flávio Alóe^I; André Pedroso^II; Stella Márcia Tavares^III

^ISleep-Wake Disorders Center (CIES) of the Faculty of Medicine of the University of São Paulo General Hospital (Hospital das Clínicas), São Paulo, Brazil: MD, Attending Neurologist

^IISleep-Wake Disorders Center (CIES) of the Faculty of Medicine of the University of São Paulo General Hospital (Hospital das Clínicas), São Paulo, Brazil: Medical student

^IIIMD, Attending Clinical Neurophysiologist and Coordinator for the Sleep Laboratory of the Hospital Israelita Albert Einstein, São Paulo, Brazil

ABSTRACT

The Epworth Sleepiness Scale (ESS) measures daytime sleepiness in adults. This paper reports the following data in 616 medical students: 1 -ESS scores, 2-its correlation with the declared night sleep time, 3-comparison with ESS values obtained from Australia, 4-comparison of ESS values in a sub-population of 111 students tested early and late 1995. There were 387 males, 185 females and 4 not specified. Age = 20.16±2.23 (SD). ESS score = 10.00 ± 3.69 (SD), declared sleep time = 7.04± 1.03 (SD). ESS scores did not statistically correlate with sleep time. Average ESS score was statistically higher than in the Australian sample. Retesting of the medical students showed an increase in ESS values from March to November 1995. Sleep time difference was non-significant. Higher ESS scores in this sample seem to be related to shorter sleep time, but fatigue effects can not be ruled out.

Key words: sleepiness, nighttime sleep, medical students, Epworth, questionnaire.

RESUMO

A Escala de Sonolência de Epworth (ESE) mede sonolência diurna em adultos. Este estudo relata os seguintes dados de 616 alunos de medicina da Faculdade de Medicina da Universidade de São Paulo: 1- média de ESE, 2- sua correlação com o número de horas de sono, 3- comparação com a média obtida na Austrália, 4- comparação dos valores de 111 alunos testados no início e no final de 1995. Valor médio da ESE = 10,00±3,69 (DP). Horas de sono = 7,04± 1,03 (DP). Os valores de ESE não se correlacionaram estatisticamente com o tempo de sono. A média da ESE foi estatisticamente maior que na amostra australiana. O reteste mostrou aumento nos valores da ESE de março a novembro de 1995, sem diferença estatística no número de horas de sono. Os valores mais altos da ESE nesta população parecem estar relacionados com sono mais curto mas os efeitos da fadiga não podem ser afastados.

Palavras-chave: sonolência, sono noturno, estudantes de medicina, Epworth, questionário.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 3-dezembro-1996.

Dr. Flávio Alóe - Rua Atlântica 460 - 01440-000 São Paulo SP - Brasil. E-mail: albeflav@spider.usp.br

1. Akersted T, Frober JE. Shift work and health: interdisciplinary aspects. In Rentos PG R, Shepard RD (eds). Shirt work and health: a symposium. Washington DC: NIOSH, 1976:179-197.
2. Aldrich MS. Cardinal manifestations of sleep disorders. In: Kryger MH, RothT, Dement WC (eds). Principles and practice of sleep medicine. New York: WB Saunders, 1989:313-319.
3. Billiard M, Alperovitch A, Perot C. Jammes A. Excessive daytime somnolence in young men: prevalence and contributing factors. Sleep 1987;10:297-305.
4. Bixler ED, Kales JB, Scharf MB, et al. Incidence of sleep disorders in medical practice: a physician survey. Sleep Res 1976:5:160.
5. Bixler ED, Kales A, Soldatos CR, Kales JB. Prevalence of sleep disorders in the Los Angeles metropolitan area. Am J Psychiatry 1979; 136:1257-1262.
6. Bonnet MH. The effect of sleep disruption on performance, sleep and mood. Sleep 1985;8:11-19.
7. Bonnet MH. Performance and sleepiness as a function of the frequency and placement of sleep disruption. Psychophysiology 1986;23:263-271.
8. Broughton R, Ghanem Q, Hishikawa Y et al. Life effects of narcolepsy in 180 patients from North America. Asia, and Europe compared to matched controls. Can J Neurol Sci 1981 ;8:299-304.
9. Carskadon MA. Guidelines for the Multiple Sleep Latency Test (MSLT): a standard measure of sleepiness. Sleep 1986;9:519-524.
10. Carskadon MA, Brown ED, Dement, WC. Sleep fragmentation in the elderly: relationship to daytime sleep tendency. Neurobiol Aging 19S 1;23:321-327.
11. Carskadon MA, Dement WC. Sleepiness during extension of nocturnal sleep. Sleep Res 1979:8:147.
12. Carskadon MA, Dement WC. Cumulative effects of sleep restriction on daytime sleepiness. Psychophysiology 1981; 18:107-113.
13. Carskadon MA, Dement WC. The multiple sleep latence test: what does it measure ? Sleep 1985; 5(Suppl): S67-S72.
14. Carskadon MA, Dement WC. Sleepiness in the normal adolescent. In Guilleminault C (eel). Sleep and its disorders in children. New York: Raven Press. 1987:53-65.
15. Herbert M, Johns ME, Doré C. Factor analysis of analogue scales measuring subjective feelings before and after sleep. Br J Med Psychol 1976;49:373-379.
16. Hoddes E, Zarcone V, Smythe H, Phillips R, Dement WC. Quantification of sleepiness: a new approach. Psychophysiology 1973:10:431-436.
¹⁷
ICSD-Internacional Classification of Sleep Disorders. Diagnostic and coding manual. Diagnostic Classification Steering Committee. Thorpy MJ, Chairman. Rochester, Minnesota: American Sleep Disorders Association. 1990.
18. Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 1991:14:540-545
19. Johns MW. Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep 1992; 15: 376-381.
20. Karacan I, Thornby JI, Anch M et al. Sleep disturbance in a primary urban Florida county. Soc Sci Med 1976;10:239-244.
21. Kripke DF, Simmons NR, Garfinkel L, Hammond EC. Short and long sleep and sleeping pills: is increased mortality associated? Arch Gen Psychiatry 1979:36:103-116.
22. Lavie P. Sleep habits and sleep disturbances in in industrial workers in Israel: main findings and some characteristics of workers complaining of excessive daytime sleepiness. Sleep 1981;4:147-158.
23. Levine B, Roehrs T, Zorick F, Roth T. Daytime sleepiness in young adults. Sleep ] 988; 11:39-46.
24. MacLcan A, Cairns J. Dose-response effects of ethanol on the sleep of young men. J Stud Alcohol 1982;43:433-444.
25. Nicholson AN, Pascoe PA, Spencer, MB, Stone MB, Roehrs T, Roth T. Sleep after transmeridian flights. Lancet 1986;2:1205-1208.
26. Parkes JD, Fenton GW. Lcvo (-) amphetemine and dextro (+) amphetamine in the treatment of narcoplesy. J Neurol Neurosurg Psychiatry 1973;36:1076-1081.
27. Pedroso A, Cherto-Filho A. Resultados da Escala de Sonolência de Epworth (ESE) em 480 alunos de graduação da Faculdade de Medicina da Universidade de São Paulo. Revista Medicina (São Paulo) 1996;75(2) (in press).
28. Richardson GS, Carskadon MA, Flagg W, Van Den Hoed J, Dement WC, Mittler MM. Excessive daytime sleepiness in man: multiple sleep latency measurements in narcoleptic vs. control subjects. Electroenceph Clin Ncurophysiol 1978;45: 621-627.
29. Richardson GS, Carskadon MA, Orav EJ, Dement WC. Circadian variation of sleep tendency in elderly and young adults subjects. Sleep 1982; 5(Suppl): S82-S94.
30. Roehrs T, Tietz E, Zorick F, Roth T. Daytime sleepiness and antihistamines. Sleep 1984;47:137-41
31. Roth T, Roehrs T, Carskadon MA, Dement WC. Daytime sleepiness and alertness. In Kryger MH, Roth T, Dement WC (eds). Principles and practice of sleep medicine. Ed 2. New York: WB Saunders, 1994:40-49.
32. Roth T, Zorick F, Sicklesteel J, Stepanski E. Effects of benzodiazepines on sleep and wakefullness. Br J Clin Pharmacol 1981;ll(Suppl):S3l-S35.
33. Roth T, Zorick F, Wittig R, Roehrs T. Pharmacological and medical considerations in hypnotic use. Sleep 1982;5(Suppl):S46-S52.
34. Schmidt-Nowara WW, Wiggins CL, Walsh JK, Bauer C. Prevalence of sleepiness in an adult population. Sleep Res 1989; 18:302.
35. Schor JB. The overworked American. New York: Basic Books, 1991.
36. Stepanski E, Lamphere J, Roehrs T, et al. Experimental sleep fragmentation in normal subjects. Int J Neurosci 1987;33:204-214
37. Wolf TM, Kissling GE Changes in life-style characteristics, health, and mood of freshman medical students. J Med Educ 1984;59:806-814.

Publication Dates

Publication in this collection
10 Nov 2010
Date of issue
June 1997

History

Received
03 Dec 1996

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Akersted T, Frober JE. Shift work and health: interdisciplinary aspects. In Rentos PG R, Shepard RD (eds). Shirt work and health: a symposium. Washington DC: NIOSH, 1976:179-197.

[2] 2. Aldrich MS. Cardinal manifestations of sleep disorders. In: Kryger MH, RothT, Dement WC (eds). Principles and practice of sleep medicine. New York: WB Saunders, 1989:313-319.

[3] 3. Billiard M, Alperovitch A, Perot C. Jammes A. Excessive daytime somnolence in young men: prevalence and contributing factors. Sleep 1987;10:297-305.

[4] 4. Bixler ED, Kales JB, Scharf MB, et al. Incidence of sleep disorders in medical practice: a physician survey. Sleep Res 1976:5:160.

[5] 5. Bixler ED, Kales A, Soldatos CR, Kales JB. Prevalence of sleep disorders in the Los Angeles metropolitan area. Am J Psychiatry 1979; 136:1257-1262.

[6] 6. Bonnet MH. The effect of sleep disruption on performance, sleep and mood. Sleep 1985;8:11-19.

[7] 7. Bonnet MH. Performance and sleepiness as a function of the frequency and placement of sleep disruption. Psychophysiology 1986;23:263-271.

[8] 8. Broughton R, Ghanem Q, Hishikawa Y et al. Life effects of narcolepsy in 180 patients from North America. Asia, and Europe compared to matched controls. Can J Neurol Sci 1981 ;8:299-304.

[9] 9. Carskadon MA. Guidelines for the Multiple Sleep Latency Test (MSLT): a standard measure of sleepiness. Sleep 1986;9:519-524.

[10] 10. Carskadon MA, Brown ED, Dement, WC. Sleep fragmentation in the elderly: relationship to daytime sleep tendency. Neurobiol Aging 19S 1;23:321-327.

[11] 11. Carskadon MA, Dement WC. Sleepiness during extension of nocturnal sleep. Sleep Res 1979:8:147.

[12] 12. Carskadon MA, Dement WC. Cumulative effects of sleep restriction on daytime sleepiness. Psychophysiology 1981; 18:107-113.

[13] 13. Carskadon MA, Dement WC. The multiple sleep latence test: what does it measure ? Sleep 1985; 5(Suppl): S67-S72.

[14] 14. Carskadon MA, Dement WC. Sleepiness in the normal adolescent. In Guilleminault C (eel). Sleep and its disorders in children. New York: Raven Press. 1987:53-65.

[15] 15. Herbert M, Johns ME, Doré C. Factor analysis of analogue scales measuring subjective feelings before and after sleep. Br J Med Psychol 1976;49:373-379.

[16] 16. Hoddes E, Zarcone V, Smythe H, Phillips R, Dement WC. Quantification of sleepiness: a new approach. Psychophysiology 1973:10:431-436.

[17] ¹⁷
ICSD-Internacional Classification of Sleep Disorders. Diagnostic and coding manual. Diagnostic Classification Steering Committee. Thorpy MJ, Chairman. Rochester, Minnesota: American Sleep Disorders Association. 1990.

[18] 18. Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 1991:14:540-545

[19] 19. Johns MW. Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep 1992; 15: 376-381.

[20] 20. Karacan I, Thornby JI, Anch M et al. Sleep disturbance in a primary urban Florida county. Soc Sci Med 1976;10:239-244.

[21] 21. Kripke DF, Simmons NR, Garfinkel L, Hammond EC. Short and long sleep and sleeping pills: is increased mortality associated? Arch Gen Psychiatry 1979:36:103-116.

[22] 22. Lavie P. Sleep habits and sleep disturbances in in industrial workers in Israel: main findings and some characteristics of workers complaining of excessive daytime sleepiness. Sleep 1981;4:147-158.

[23] 23. Levine B, Roehrs T, Zorick F, Roth T. Daytime sleepiness in young adults. Sleep ] 988; 11:39-46.

[24] 24. MacLcan A, Cairns J. Dose-response effects of ethanol on the sleep of young men. J Stud Alcohol 1982;43:433-444.

[25] 25. Nicholson AN, Pascoe PA, Spencer, MB, Stone MB, Roehrs T, Roth T. Sleep after transmeridian flights. Lancet 1986;2:1205-1208.

[26] 26. Parkes JD, Fenton GW. Lcvo (-) amphetemine and dextro (+) amphetamine in the treatment of narcoplesy. J Neurol Neurosurg Psychiatry 1973;36:1076-1081.

[27] 27. Pedroso A, Cherto-Filho A. Resultados da Escala de Sonolência de Epworth (ESE) em 480 alunos de graduação da Faculdade de Medicina da Universidade de São Paulo. Revista Medicina (São Paulo) 1996;75(2) (in press).

[28] 28. Richardson GS, Carskadon MA, Flagg W, Van Den Hoed J, Dement WC, Mittler MM. Excessive daytime sleepiness in man: multiple sleep latency measurements in narcoleptic vs. control subjects. Electroenceph Clin Ncurophysiol 1978;45: 621-627.

[29] 29. Richardson GS, Carskadon MA, Orav EJ, Dement WC. Circadian variation of sleep tendency in elderly and young adults subjects. Sleep 1982; 5(Suppl): S82-S94.

[30] 30. Roehrs T, Tietz E, Zorick F, Roth T. Daytime sleepiness and antihistamines. Sleep 1984;47:137-41

[31] 31. Roth T, Roehrs T, Carskadon MA, Dement WC. Daytime sleepiness and alertness. In Kryger MH, Roth T, Dement WC (eds). Principles and practice of sleep medicine. Ed 2. New York: WB Saunders, 1994:40-49.

[32] 32. Roth T, Zorick F, Sicklesteel J, Stepanski E. Effects of benzodiazepines on sleep and wakefullness. Br J Clin Pharmacol 1981;ll(Suppl):S3l-S35.

[33] 33. Roth T, Zorick F, Wittig R, Roehrs T. Pharmacological and medical considerations in hypnotic use. Sleep 1982;5(Suppl):S46-S52.

[34] 34. Schmidt-Nowara WW, Wiggins CL, Walsh JK, Bauer C. Prevalence of sleepiness in an adult population. Sleep Res 1989; 18:302.

[35] 35. Schor JB. The overworked American. New York: Basic Books, 1991.

[36] 36. Stepanski E, Lamphere J, Roehrs T, et al. Experimental sleep fragmentation in normal subjects. Int J Neurosci 1987;33:204-214

[37] 37. Wolf TM, Kissling GE Changes in life-style characteristics, health, and mood of freshman medical students. J Med Educ 1984;59:806-814.