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ORIGINAL ARTICLE
Year : 2019  |  Volume : 21  |  Issue : 1  |  Page : 36-40

Epworth sleepiness score to predict sleep apnea in acute stroke: Do we need to delve deeper?


Department of Medicine, INHS Asvini, Mumbai, Maharashtra, India

Correspondence Address:
Surg Capt Pulikottil Wilson Vinny
Department of Medicine, INHS Asvini, Colaba, Mumbai - 400 005, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmms.jmms_50_18

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Introduction: Globally, stroke is a leading cause of death and disability. Obstructive sleep apnea (OSA) is globally being recognized as an emerging public health problem and a risk factor for stroke. Epworth Sleepiness Score (ESS) is increasingly being used as a screening tool to determine the likelihood of OSA in a patient before polysomnography (PSG). However, ESS questionnaires in patients with acute stroke and their comparison with overnight PSG have not been studied. We conducted this study at a tertiary care respiratory center in Mumbai to determine the effectiveness of ESS in predicting the prevalence of sleep apnea in acute ischemic stroke. Materials and Methods: Twenty-eight patients of acute stroke were included in the study. These patients were subjected to ESS and technician attended overnight PSG. Apnea–Hypopnea Index, oxygen desaturation index, and minimum saturation were determined at the overnight PSG. Results: Majority of patients belonged to 61–80 years' age group (53.6%) and were predominantly male (89.3%). Only 5 patients (17.9%) showed an ESS of more than 8, whereas 23 patients (82.1%) showed evidence of OSA on PSG. Sensitivity of ESS in predicting OSA in patients with acute stroke was 17.3%, whereas specificity was 80%. Conclusion: The use of ESS in patients of acute stroke to screen for sleep-disordered breathing (SDB) should be avoided. A PSG may be considered in these patients as early diagnosis of SDB in these patients can help in improving recovery.


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