Revision and reliability and validity testing of the Epworth Sleepiness Scale in a college student population

Shi Xuliang; Sun Yuqing; Zhou Tianli; Liu Jiale; Zhu Ya

doi:10.11986/j.issn.1673-873X.2024.02.006

Abstract：Objective This study aimed to revise the Chinese version of the Epworth Sleepiness Scale-Revised(ESSR)and examine its reliability and validity in a college student population in China.Methods ESSR was administered to 11 755 col-lege students.Half of the students were randomly selected for exploratory factor analysis,while the other half underwent confirmatory factor analysis.The criterion-related validity was assessed using the Sleep Disorders Self-Assessment Ques-tionnaire,Depression Symptom Screening Scale,Adult Anxiety Disorder Screening Scale,Morningness-Eveningness Ques-tionnaire-Short Form,and Daytime Functioning Assessment Questionnaire.After a 4-week interval,105 college students were randomly selected for ESSR retest to examine test-retest reliability.Additionally,the optimal diagnostic cutoff value for ESSR was determined using receiver operating characteristic(ROC)curve analysis.Results Correlation analysis be-tween each item score and the total score of ESSR showed correlation coefficients ranging from 0.57 to 0.69,all of which were significant(P＜0.05).Pearson correlation analysis revealed significant positive correlations between ESSR with in-somnia symptoms,sleep breathing disorders,depression symptoms,generalized anxiety,and daytime functioning,as well as a negative correlation with chronotype scores(P＜0.05).ROC curve analysis indicated that when the total score of ESSR was 8.5,the Youden index was maximized(0.38),with a sensitivity of 60.74％,specificity of 77.41％,and area under the curve of 0.75.Conclusion ESSR demonstrates good reliability and validity in a college student population in China,making it an effective tool for measuring and assessing the degree of sleepiness in Chinese college students.