title: Change in Epworth Sleepiness Scale after surgical treatment of obstructive sleep apnea.
abstract: OBJECTIVE
  To evaluate the effect of surgical intervention for obstructive sleep apnea (OSA) on patients' level of excessive daytime sleepiness as determined by the Epworth Sleepiness Scale (ESS). The ESS questionnaire is a validated measure of subjective daytime sleepiness. There have been several studies that have shown that continuous positive airway pressure (CPAP) improves excessive daytime sleepiness in OSA patients as measured by the ESS.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  This is a study of patients who had uvulopalatopharyngoplasty (UPPP); UPPP and tonsillectomy; or UPPP, tonsillectomy, and radiofrequency ablation of the base of the tongue for OSA between January 2007 and December 2009. Forty patients were identified who met the criteria of having had an ESS evaluation and polysomnography prior to surgery for OSA.
  
  
  RESULTS
  Across all of the patients there was a mean reduction of their ESS by 5.6 ± 4.1; t = 8.82, P < .001. Only three of the patients did not improve in their ESS scores after surgical treatment for OSA.
  
  
  CONCLUSIONS
  Surgical intervention for OSA significantly improves sleepiness in OSA patients as measured by the ESS. Two meta-analyses of multiple, randomized, controlled studies showed patients with mild to moderate OSA treated with CPAP demonstrated an improvement in the ESS score of 1.2 points (95% confidence interval, 0.05-1.9, P = .001) and 2.94 points for patients with mild to severe OSA treated with CPAP. The results of this study show an improvement in ESS after surgery that is substantially higher than previously reported with CPAP for all categories of OSA.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan 48202, USA. kyaremc1@hfhs.org
authors.forename: Kathleen
authors.initials: K
authors.lastname: Yaremchuk
authors.forename: Brandy
authors.initials: B
authors.lastname: Tacia
authors.forename: Edward
authors.initials: E
authors.lastname: Peterson
authors.forename: Thomas
authors.initials: T
authors.lastname: Roth
mesh_terms: D000328:Adult; D017115:Catheter Ablation / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D017286:Polysomnography / Q000379:methods; D011175:Positive-Pressure Respiration / Q000379:methods; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000601:surgery* / Q000628:therapy; D020178:Sleep Disorders, Circadian Rhythm / Q000175:diagnosis* / Q000453:epidemiology; D014068:Tonsillectomy / Q000379:methods; D016896:Treatment Outcome