Abstract Details

Title The Epworth Sleepiness Scale in Epilepsy: Internal Consistency and Disease-Related Associations

Topic Sleep

Presentation(s) Sleep Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 029

Background The Epworth Sleepiness Scale (ESS) is the most common instrument for measuring subjective sleep propensity in people with epilepsy, but has not yet been validated in this population.

Objective We aimed to systematically assess the validity, performance, and internal consistency of the ESS, as well as correlations between the ESS and disease-specific variables and patient-reported outcome measures (PROMs) in a cohort of adults with epilepsy (AWE).

Design/Methods 95 AWE completed sleep and seizure diaries, in-laboratory polysomnography, and PROMs, including the ESS, Insomnia Severity Index (ISI), and the Beck Depression Inventory (BDI). Data from 95 matched obstructive sleep apnea (OSA) controls were taken from the electronic medical record. Frequencies of high ESS item ratings (item score ≥2) were calculated for each group. Cronbach’s α and factor analysis were performed to assess the internal consistency and validity of the ESS within cases and controls. Multivariable linear models were used to assess the association between ESS and predictors of interest, adjusting for demographic and disease-specific variables.

Results While OSA controls had significantly greater mean ESS total scores (9.9 vs 7.9, p=0.004) and proportion with ESS>10 (42% vs 25%, p=0.014), there were no significant differences in item response, with the exception of “lying down to rest in the afternoon when circumstances permit,” for which more controls rated as likely/very likely (79% vs 64%), p=0.024). AWE with ESS >10 had higher mean standardized anti-seizure-medication dose (2.5 vs 1.7, p=0.026). All ESS items were significantly correlated with the total score within each group. Cronbach’s α was 0.75 for cases and 0.85 for controls, indicating good internal consistency of the ESS for both groups. After adjusting for demographic and sleep characteristics, higher ESS scores were associated with greater/worse ISI (p=0.024) and BDI (p=0.018) scores.

Conclusions This study provides validity for the use of the ESS in adult epilepsy populations.

Authors/Disclosures
Maeve M. Pascoe (Cleveland Clinic Lerner College of Medicine) PRESENTER	Ms. Pascoe has nothing to disclose.
	No disclosure on file
	No disclosure on file
Madeleine M. Grigg-Damberger, MD (University of New Mexico, Department of Neurology)	Dr. Grigg-Damberger has received personal compensation for serving as an employee of Oxford University Press. Dr. Grigg-Damberger has received personal compensation for serving as an employee of Up-to-date. Dr. Grigg-Damberger has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Clinical Sleep Medicine. Dr. Grigg-Damberger has received publishing royalties from a publication relating to health care.
	No disclosure on file
Nancy R. Foldvary-Schaefer, DO, FAAN (Cleveland Clinic)	Dr. Foldvary-Schaefer has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jazz. The institution of Dr. Foldvary-Schaefer has received research support from Jazz. The institution of Dr. Foldvary-Schaefer has received research support from Suven. The institution of Dr. Foldvary-Schaefer has received research support from Takeda. Dr. Foldvary-Schaefer has received publishing royalties from a publication relating to health care. Dr. Foldvary-Schaefer has received publishing royalties from a publication relating to health care.