title: Prevalence of High Epworth Sleepiness Scale scores in a rural population.
abstract: BACKGROUND
  Increased daytime sleepiness is an important symptom of obstructive sleep apnea (OSA). OSA is frequently underdiagnosed, and the Epworth Sleepiness Scale (ESS) can be a useful tool in alerting physicians to a potential problem involving OSA.
  
  
  OBJECTIVE
  To measure the prevalence and determinants of daytime sleepiness measured using the ESS in a rural community population.
  
  
  METHODS
  A community survey was conducted to examine the risk factors associated with ESS in a rural population in 154 households comprising 283 adults. Questionnaire information was obtained regarding physical factors, social factors, general medical history, family medical history, ESS score, and self-reported height and weight. Multivariable binary logistic regression analysis based on the generalized estimating equations approach to account for clustering within households was used to predict the relationship between a binary ESS score outcome (normal or abnormal) and a set of explanatory variables.
  
  
  RESULTS
  The population included 140 men (49.5%) and 143 women (50.5%) with an age range of 18 to 97 years (mean [± SD] 52.0±14.9 years). The data showed that 79.2% of the study participants had an ESS score in the normal range (0 to 10) and 20.8% had an ESS score >10, which is considered to be abnormal or high sleepiness. Multivariable regression analysis revealed that obesity was significantly associated with an abnormal or high sleepiness score on the ESS (OR 3.40 [95% CI 1.31 to 8.80).
  
  
  CONCLUSIONS
  High levels of sleepiness in this population were common. Obesity was an important risk factor for high ESS score.
authors.affiliation: Canadian Centre for Health and Safety in Argiculture, University of Saskatchewan, Saskatoon, Saskatchewan. pup165@mail.usask.ca
authors.forename: P
authors.initials: P
authors.lastname: Pahwa
authors.forename: C P
authors.initials: CP
authors.lastname: Karunanayake
authors.forename: L
authors.initials: L
authors.lastname: Hagel
authors.forename: J A
authors.initials: JA
authors.lastname: Gjevre
authors.forename: D
authors.initials: D
authors.lastname: Rennie
authors.forename: J
authors.initials: J
authors.lastname: Lawson
authors.forename: J A
authors.initials: JA
authors.lastname: Dosman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010865:Pilot Projects; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012424:Rural Population; D012525:Saskatchewan / Q000453:epidemiology; D057566:Self Report; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult