Body Mass Index, Gender, and Ethnic Variations Alter the Clinical Implications of the Epworth Sleepiness Scale in Patients with Suspected Obstructive Sleep Apnea§

Fig. (2) Test characteristics of the Epworth Sleepiness Scale (ESS) in the diagnosis of obstructive sleep apnea (OSA), related to gender, ethnicity, and body mass index. (A) The sensitivity and specificity of the ESS for the diagnosis of OSA are plotted for the overall study population (N = 1900), males (N = 1092), females (N = 805), Caucasians (N = 998), Hispanics (N = 856), other races (N = 46), obese (N = 1370), and non-obese (N = 529). (B) The sensitivity and specificity of the ESS for the diagnosis of OSA are plotted for obese Caucasian males (OCM, N = 397), non-obese Caucasian males (NCM, N = 198), obese Hispanic males (OHM, N = 364), non-obese Hispanic males (NHM, N = 104), obese Caucasian females (OCF, N = 269), non-obese Caucasian females (NCF, N = 130), obese Hispanic females (OHF, N = 303), and non-obese Hispanic females (NHF, N = 82).