Effect size analysis of the Epworth Sleepiness Scale

Rühle and colleagues (2005) researched into an effect size analysis of the ESS the question, if daytime sleepiness could be investigated through a situation. Therefore, the authors analyzed the effect sizes of the eight items. From methodological considerations, it was reasonable to imagine, to come across items with good to very good discriminatory power, because the ESS has a good to very good reliability and validity.

In the study, which took place in the sleep laboratory of the Helios Clinic in Hagen-Ambrock, 209 male OSAS patients and 164 healthy subjects participated. To calculate the effect sizes for each item the difference between of the two item means (of patients and healthy subjects) was divided by the standard deviation of the normal population. Rühle et al. received low to very good effect sizes (ES) between 0.19 to 1.50 The best effect sizes were found for the situation "in reading" (ES = 1.50), "watching TV" (ES = .90), "sit and be passive" (ES = .85) and for "traffic-related stopping" (ES = .61). Similarly, there was an increased mean effect size of ES = .88 for the four selected items, compared to a mean effect size of ES = .68 for the total scale. Some situations of ESS was associated with both healthy subjects and OSAS patients with a high propensity for sleep, e.g. to "lie down to rest" (ES = .19), as a "passenger" (ES = .22) and "talk with someone sitting" (ES = .24). For the development of everyday life and job-related tests - as it had been suggested by Johns (2000), the reading activity was an important characterisation of daytime sleepiness, because it discriminates at the best between OSAS patients and healthy individuals in comparison to the other ESS items.

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