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Vol. 36. Issue 8.
Pages 436-440 (September 2000)
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Vol. 36. Issue 8.
Pages 436-440 (September 2000)
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Evaluación de la somnolencia diurna excesiva en conductores profesionales con sospecha de síndrome de apnea obstructiva durante el sueño
Assessment of excessive daytime sleepiness in professional drivers suspected of obstructive sleep apnea syndrome
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C. Carmona Bernal1, F. Capote Gil, P. García López, A. Sánchez Armengol, J. Castillo Gómez
Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Hospitales Universitarios Virgen del Rocío. Sevilla
G. Botebol Benhamou*
* Servicio de Neurofisiología Clínica. Hospitales Universitarios Virgen del Rocío. Sevilla
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La somnolencia diurna excesiva es un síntoma frecuente en el síndrome de apnea obstructiva durante el sueño, y puede ser causante de accidentes de tráfico. Este aspecto tiene especial importancia en los conductores profesionales, por la morbimortalidad y repercusión laboral que puede suponer. Hemos evaluado si la escala de somnolencia de Epworth (ESE) (medida subjetiva de la somnolencia diurna) se correlaciona bien con el test de latencia múltiple del sueño (TLMS) (medida objetiva de la somnolencia diurna). Además, hemos comparado ambos métodos con algunos parámetros de la polisomnografía (PLSG) (índice de apnea-hipopnea, índice de arousals y saturación de oxígeno mínima). Hemos estudiado a 55 conductores profesionales con sospecha de síndrome de apnea obstructiva durante el sueño. A todos se les aplicó la ESE y se les realizó una PLSG y un TLMS. Encontramos una correlación significativa, aunque no relevante, entre el grado de somnolencia diurna excesiva estimada mediante la ESE y la medida por el TLMS (r = –0,41; p = 0,002). Al comparar ambos métodos con la PLSG, tan sólo encontramos una correlación significativa, aunque muy débil, entre la ESE y el índice de arousals (r = 0,26; p<0,05). Según nuestros resultados, no está claro cuál es el mejor método para medir la somnolencia diurna excesiva en conductores profesionales con sospecha de síndrome de apnea obstructiva durante el sueño.

Palabras clave:
Síndrome de apnea obstructiva durante el sueño
Somnolencia diurna excesiva
Test de latencia múltiple del sueño
Escala de somnolencia de Epworth

Excessive daytime sleepiness is a common symptom of obstructive sleep apnea syndrome (OSAS) and can be a cause of traffic accidents, creating a problem of particular importance for professional drivers given the associated death, disability and professional repercussions. We assessed whether the Epworth sleepiness scale (ESS), which is a subjective measure of daytime sleepiness, correlates well with multiple sleep latency (MSL) testing, which gives an objective measure of daytime sleepiness. We also compared each method with the results of polysomnography (apnea-hypopnea index, arousal index and minimum oxygen saturation). We studied 55 professional drivers suspected of OSAS. All answered the ESS questionnaire and underwent polysomnographic and MSL testing. We found a significant, though not relevant, correlation between the degree of excessive daytime sleepiness estimated by the ESS and by MSL testing (r = -0.41; p = 0.002). A significant, though weak, correlation was found between the ESS score and the arousal index (r = 0.26; p<0.05). Our results do not clarify which method is best for measuring excessive daytime sleepiness in professional drivers suspected of OSAS.

Key words:
Obstructive sleep apnea syndrome
Excessive daytime sleepiness
Multiple sleep latency test
Epworth sleepiness scale
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Bibliografía
[1.]
C. Guilleminault.
Clinical features and evaluation of obstructive sleep apnea.
Principles and practice of sleep medicine, pp. 552-558
[2.]
B. Naëgelé, V. Thouvard, J. Pépin, et al.
Deficits of cognitive executive functions in patients with sleep apnea syndrome.
Sleep, 18 (1995), pp. 43-52
[3.]
J.W. Shepard.
Excessive daytime sleepiness, upper airway resistance, and nocturnal arousals.
Chest, 104 (1993), pp. 665-666
[4.]
L.J. Findley, R.J. Bonnie.
Sleep apnea and auto crashes.
What is the doctor to do?. Chest, 94 (1988), pp. 225-226
[5.]
American Sleep Disorders Association.
The clinical use of the multiple latency test.
Sleep, 15 (1992), pp. 268-276
[6.]
M.W. Johns.
Daytime sleepiness, snoring, and obstructive sleep apnea.
The Epworth sleepiness scale. Chest, 103 (1993), pp. 30-36
[7.]
M.W. Johns.
A new method for measuring daytime sleepiness: the Epworth sleepiness scale.
Sleep, 14 (1991), pp. 540-545
[8.]
A. Rechtschaffen, A. Kales.
A manual of standardized terminology techniques and scoring system for sleep states human subjects.
National Institute of Neurological Disease and Blindness, NIH. Publication, (1968),
[9.]
N.J. Moser, B.A. Phillips, D.T.R. Berry, L. Harbison.
What is hypopnea, anyway?.
Chest, 105 (1994), pp. 426-428
[10.]
American Sleep Disorders Association.
EEG Arousals: scoring rules and examples.
Sleep, 15 (1992), pp. 173-184
[11.]
H.M. Engleman, K.E. Cheshire, I.J. Deary, N.J. Douglas.
Daytime sleepiness, cognitive performance and mood after continuous airway pressure for the sleep apnoea-hypopnoea syndrome.
Thorax, 48 (1993), pp. 911-914
[12.]
S. Redline, K.P. Strohl.
Recognition and consequences of obstructive sleep apnea hypopnea syndrome.
Clin Chest Med, 19 (1998), pp. 1-20
[13.]
S.G. McNamara, R.R. Grunstein, C.E. Sullivan.
Obstructive sleep apnoea.
Thorax, 48 (1993), pp. 754-764
[14.]
W.T. McNicholas.
Diagnostic criteria for the sleep apnoea syndrome: time for consensus?.
Eur respir J, 9 (1996), pp. 634-635
[15.]
L.S. Bennet, J.R. Stradling.
Who should receive treatment for sleep apnoea?.
Thorax, 52 (1997), pp. 103-104
[16.]
T. Young, M. Palta, J. Dempsey.
The occurrence of sleep-disordered breathing among middle-aged adults.
N Engl J Med, 328 (1993), pp. 1230-1235
[17.]
B.D. Crocker, L.G. Olson, N.A. Saunders, et al.
Estimation of the probability of disturbed breathing during sleep before a sleep study.
Am Rev Respir Dis, 142 (1990), pp. 14-18
[18.]
M. Johns, B. Hocking.
Daytime sleepiness and sleep habits of australian workers.
Sleep, 20 (1997), pp. 844-849
[19.]
F. Barbé, J. Pericás, A. Muñoz, L. Findley, J.M. Antó, A.G.N. Agustí.
Automobile accidents in patients with sleep apnea syndrome.
An epidemiological and mechanistic study. Am J Respir Crit Care Med, 158 (1998), pp. 18-22
[20.]
R. Stoohs, L. Bingham, A. Itoi, C. Guilleminault, C. Dement.
Sleep and sleep-disordered breathing commercial long-haul truck drivers.
Chest, 107 (1995), pp. 1275-1282
[21.]
J. Terán-Santos, A. Jiménez-Gómez, J. Cordeto-Guevara, et al.
The association between sleep apnea and the risk of traffic accidents.
N Engl J Med, 340 (1999), pp. 847-851
[22.]
P.M. Suratt, L.J. Findley.
Driving with sleep apnea.
N Engl J Med, 340 (1999), pp. 881-883
[23.]
K. Martikainen, H. Urponen, M. Partinen, J. Hasan, I. Vuori.
Daytime sleepiness: a risk factor in community life.
Acta Neurol Scand, 86 (1992), pp. 337-341
[24.]
H. Moldofsky.
Evaluation of daytime sleepiness.
Clin Chest Med, 13 (1992), pp. 417-425
[25.]
A. Sánchez Armengol, S. Cano Gómez, F. Capote Gil, E. García Diaz, C. Carmona Bernal, J. Castillo Gómez.
Detección del síndrome de apnea obstructiva del sueño en una población de conductores profesionales.
An Med Intern (Madrid), 14 (1997), pp. 547-553
[26.]
C. Guilleminault, R. Stoohs, A. Clerk, J. Simmons, M. Labanowski.
From obstructive sleep apnea syndrome to upper airway resistance syndrome: consistency of daytime sleepiness.
Sleep, 15 (1992), pp. S13-S16
[27.]
American Thoracic Society.
Sleep apnea, sleepiness and driving risk.
Am J Resp Crit Care Med, 150 (1994), pp. 1463-1473
[28.]
C. Guilleminault, M. Partinen, M.A. Quera-Salva, B. Hayes, W.C. Dement, G. Nino-Murcia.
Determinants of daytime sleepiness in obstructive sleep apnea.
Chest, 94 (1998), pp. 32-37
[29.]
R.N. Kingshott, H.M. Engleman, I.J. Deary, N.J. Douglas.
Does arousal frequency predict daytime function?.
Eur Respir J, 12 (1998), pp. 1264-1270
[30.]
T. Roehrs, F. Zorick, R. Wittig, W. Conway, T. Roth.
Predictors of objective level of daytime sleepiness in patients with sleep-related breathing disorders.
Chest, 95 (1989), pp. 1202-1206
[31.]
R.B. Sangal, J.M. Sangal.
Abnormal visual P300 latency in obstructive sleep apnea does not change acutely upon treatment with CPAP.
Sleep, 20 (1997), pp. 702-704
[32.]
N.B. Kribbs, A.I. Pack, L.R. Kline, et al.
Effects of one night without nasal CPAP treatment on sleep and sleepiness in patients with obstructive sllep apnea.
Am Rev Respir Dis, 147 (1993), pp. 1162-1168
[33.]
J.C. Meurice, J. Paquereau, P. Neau, et al.
Long-term evolution of daytime somnolence in patients with sleep apnea/hypopnea syndrome treated by continuous positive airway pressure.
Sleep, 20 (1997), pp. 1162-1166
[34.]
J. Walsleben.
The measurement of daytime wakefulness.
Chest, 101 (1992), pp. 890-891
[35.]
R.B. Sangal, L. Thomas, M.M. Mitler.
Maintenance of wakefulness test and multiple sleep latency test.
Measurement of different abilities in patients with sleep disorders. Chest, 101 (1992), pp. 898-902
[36.]
J.S. Poceta, R.M. Timms, D. Jeong, S. Ho, M.K. Erman, M.M. Mitler.
Maintenance of wakefulness test in obstructive sleep apnea syndrome.
Chest, 101 (1992), pp. 893-897
[37.]
M.W. Johns.
Reliability and factor analysis of the Epworth sleepiness scale.
Sleep, 15 (1992), pp. 376-381
[38.]
C.W. Whitney, P.L. Enright, A.B. Newman, W. Bonekat, D. Foley, F. Quan.
Correlates of daytime sleepiness in 4578 elderly persons: the cardiovascular health study.
Sleep, 21 (1998), pp. 27-36
[39.]
R.D. Chervin, M.S. Aldrich, R. Pickett, C. Guilleminault.
Comparison of the results of the Epworth sleepiness scale and the multiple sleep latency test.
J Psychosom Res, 42 (1997), pp. 145-155
[40.]
R.D. Chervin, M.S. Aldrich.
The Epworth sleepiness scale may not reflect objective measures of sleepiness or sleep apnea.
Neurology, 52 (1999), pp. 125-131
[41.]
Y. Izquierdo-Vicario, M.J. Ramos-Platón, D. Conesa-Peraleja, A.B. Lozano- Parra, J. Espinar-Sierra.
Epworth sleepiness scale in a sample of the Spanish population.
Sleep, 20 (1997), pp. 676-677
[42.]
S.E. Martin, H.M. Engleman, I.J. Deary, N.J. Douglas.
Comparison of microarousal definitions in patients with sleep apnea.
Am J Res Crit Care Med, 151 (1995), pp. A154
[43.]
S.E. Martin, H.M. Engleman, R.N. Kingshott, N.J. Douglas.
Microarousals in patients with sleep apnoea/hypopnea syndrome.
J Sleep Res, 6 (1997), pp. 276-280
[44.]
S. Berg, S. Nash, P. Cole, V. Hoffstein.
Arousals and nocturnal respiration in symptomatic snorers and nonsnorers.
Sleep, 20 (1997), pp. 1157-1161
[45.]
W.T. McNicholas.
Arousals in the sleep apnoea syndrome: a mixed blessing?.
Eur Respir J, 12 (1998), pp. 1239-1241
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