ArticleSleep & breathing = Schlaf & Atmung2023
The language of sleepiness in obstructive sleep apnea beyond the Epworth.
Article in Sleep & breathing = Schlaf & Atmung, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 19 citations in OpenAlex.
- What do we know about the Epworth Sleepiness Scale in women? A review of the evidence.Sleep medicine reviews · 2026Review
- Effects of Treating Obstructive Sleep Apnea on Common Symptoms of HIV.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- Article
- Sleepiness and Fatigue as Consequences of Cumulative Sleep Restriction: Insights from Fine-Grained Subjective Measures and Skin Temperature in the Field.Clocks & sleep · 2025Article
- Association of Chrono-Nutritional Profiles with Weight Loss and Comorbidity Remission After Bariatric Surgery in Patients with Severe Obesity.Nutrients · 2025Article
- Adherence to unilateral hypoglossal nerve stimulation and changes in Epworth Sleepiness Scale scores.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Sleep disorders after cardiac arrest: Prevalence and relation with cognitive function.Resuscitation plus · 2025Article
- A Prospective Observational Study Investigating the Relationship Between Vitamin D Deficiency and STOP-Bang Parameters in Elderly Populations.Nature and science of sleep · 2025Article
- Factors predictive of extensive use of CPAP treatment in obstructive sleep apnoea.Sleep & breathing = Schlaf & Atmung · 2024Article
- Chronic obstructive pulmonary disease and obstructive sleep apnea overlap: who to treat and how?Expert review of respiratory medicine · 2024Review
- Tirzepatide for the treatment of obstructive sleep apnea: Rationale, design, and sample baseline characteristics of the SURMOUNT -OSA phase 3 trial.Contemporary clinical trials · 2024Article
- Evolution of adherence and self-reported symptoms over 36 months with mandibular advancement device therapy for obstructive sleep apnea: a retrospective study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Match and Mismatch between Lived Experiences of Daytime Sleepiness and Diagnostic Instruments: A Qualitative Study amongst Patients with Sleep Disorders.Clocks & sleep · 2024Article
- Revealing inconsistencies between Epworth scores and apnea-hypopnea index when evaluating obstructive sleep apnea severity: a clinical retrospective chart review.Frontiers in neurology · 2024Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
Abstract
purposeObstructive sleep apnea (OSA) is underdiagnosed, partially from variable clinical presentations. Emphasis is often placed on Epworth Sleepiness Scale (ESS), a subjective measure of sleepiness, but variable in OSA. We hypothesized that daytime complaints measured with Language of Sleepiness Questionnaire (LOS) in OSA are not being captured by ESS.
methodsAdults referred to a tertiary sleep clinic undergoing sleep studies completed ESS and LOS questionnaires (20 items with various patient-reported descriptors). LOS was examined in patients who had or did not have OSA without sleepiness based on ESS < 10. Cluster analysis was performed to assess whether or not groups of individuals differed based on classification with or without OSA and with or without ESS-based sleepiness.
resultsApproximately half the study population (n = 185 completed) had OSA. ESS score (mean ± SD) was 9.0 ± 5.4. There was no significant difference in ESS between patients with and without OSA (9.0 ± 5.1 vs 9.1 ± 5.7, p = 0.969). In patients with OSA, females, older patients and white patients were significantly less likely to have an ESS ≥ 10 when compared to patients with an ESS < 10. In patients with an ESS < 10, there were no significant differences in descriptors of sleepiness between patients with and without OSA with the most common descriptors selected being "I lack energy," "I wake up sleepy," "I keep waking up," and "I don't sleep enough."
conclusionsThe ESS failed to discriminate patients with OSA from those without OSA. Despite an ESS < 10, both daytime and sleep complaints using the LOS questionnaire were present in patients with OSA. Asymptomatic OSA may be less common than previously reported.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.