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The Epworth Sleepiness Scale: translation and validation study of the Iranian version

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Abstract

Purpose

The main purpose of this study was to assess the reliability and validity of the Iranian version of the Epworth Sleepiness Scale (ESS-IR).

Methods

This was a cross-sectional study of 507 suspicious patients either to obstructive sleep apnea (n = 466) or narcolepsy (n = 41) in order to carry out a psychometric evaluation of the ESS-IR by performing reliability, validity, and responsiveness analyses. Reliability of the ESS-IR was assessed by internal consistency and test–retest reliability. Validity of the instrument was assessed using several statistical approaches including construct validity (exploratory factor analysis), discriminant validity, and criterion validity. Responsiveness of the ESS-IR was assessed by comparing the ESS-IR total score before and after 6–9 months of continues positive airway pressure (CPAP) treatment in 16 patients with obstructive sleep apnea (OSA).

Results

The ESS-IR had an acceptable internal consistency and test–retest reliability. Factor analysis in both groups showed a two-factor solution for the ESS-IR, but the first factor showed statistically significant loads in all items. In addition, the ESS-IR discriminated well between patients with and without OSA. There is a fair correlation between the ESS-IR total score and multiple sleep latency test results that is not significant at all. Finally, the ESS-IR was found to be responsive to change where the total score was significantly decreased after CPAP treatment (P < 0.001).

Conclusion

The findings suggest that the ESS-IR is a reliable and valid measure for evaluating daytime sleepiness and now can be used in research and clinical settings in Iran.

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Acknowledgments

The authors wish to thank the sleep laboratory staff for their support.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Baharloo Sleep Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Khosro Sadeghniiat Haghighi, Ahmad Khajeh Mehrizi & Ania Rahimi Golkhandan

  2. Mental Health Research Group, Mother and Child Health Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran

    Ali Montazeri

  3. Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran

    Khosro Sadeghniiat Haghighi, Omid Aminian & Maryam Saraei

  4. Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Mojtaba Sedaghat

Authors
  1. Khosro Sadeghniiat Haghighi
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  2. Ali Montazeri
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  3. Ahmad Khajeh Mehrizi
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  4. Omid Aminian
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  5. Ania Rahimi Golkhandan
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  7. Mojtaba Sedaghat
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Corresponding author

Correspondence to Ahmad Khajeh Mehrizi.

Appendix

Appendix

Iranian version of the Epworth Sleepiness Scale

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Sadeghniiat Haghighi, K., Montazeri, A., Khajeh Mehrizi, A. et al. The Epworth Sleepiness Scale: translation and validation study of the Iranian version. Sleep Breath 17, 419–426 (2013). https://doi.org/10.1007/s11325-012-0646-x

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  • DOI: https://doi.org/10.1007/s11325-012-0646-x

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