title: What is the best measure of daytime sleepiness in adults with heart failure?
abstract: OBJECTIVE
  To identify the best screening measure of daytime sleepiness in adults with heart failure (HF).
  
  
  METHODS
  A total of 280 adults with HF completed the Epworth Sleepiness Scale, the Stanford Sleepiness Scale, and a single Likert item measuring daytime sleepiness. The sensitivity and specificity of these self-report measures were assessed in relation to a measure of daytime dysfunction from poor sleep quality.
  
  
  CONCLUSIONS
  Only 16% of the sample reported significant daytime dysfunction because of poor sleep quality. Those reporting daytime dysfunction were likely to be younger (p < .001), to be unmarried (p = .002), to have New York Heart Association (NYHA) functional class IV HF (p = .015), and to report low income (p = .006) and fewer hours of sleep (p = .015). The measure of daytime sleepiness that was most sensitive to daytime dysfunction was a single Likert item measured on a 10-point (1-10) scale. Patients with a score ≥4 were 2.4 times more likely to have daytime dysfunction than those with a score <4.
  
  
  CONCLUSIONS
  Complaints of daytime dysfunction because of poor sleep are not common in adults with HF. Routine use of a single question about daytime sleepiness can help nurse practitioners to identify those HF patients with significant sleep issues that may require further screening.
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Hanlon
authors.forename: Xuemei
authors.initials: X
authors.lastname: Zhang
authors.forename: Desiree
authors.initials: D
authors.lastname: Fleck
authors.forename: Steven L
authors.initials: SL
authors.lastname: Sayers
authors.forename: Lee R
authors.initials: LR
authors.lastname: Goldberg
authors.forename: William S
authors.initials: WS
authors.lastname: Weintraub
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012648:Self Care; D057566:Self Report; D012680:Sensitivity and Specificity; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D012959:Socioeconomic Factors
keywords: Heart failure; outcomes; screening; sleep disorders