This study was conducted in a cross-sectional, prospective manner and included 93 people who were presented in XXXXXXX for snoring and apnea problems and who had undergone polysomnography tests. Excluded from the study were people with a diagnosis of another sleep disorder (e.g., narcolepsy, periodic limb sleep movements [PLSM], or rapid-eye-movement [REM] behavior disorder [RBD]) who were admitted to the outpatient clinic for evaluation after continuous positive airway pressure (CPAP) or surgical treatment, and people with cognitive disorders or communication problems. ESS is used to measure daytime sleepiness in various situations based on self-reporting.

The participants in this study answered the self-reporting ESS (ESSp) questionnaire while alone in the waiting room and without the help of a physician or their family members. ESS was later repeated, but this time, it was verbally administered by a sleep medicine physician (ESSd), who explained the questionnaire items to the patients and filled out the questionnaire himself with the patients’ answers. The sleep medicine physician did not influence the patients’ answers but only made these more precise. ESS is scored on the basis of a 4-point (0, 1, 2, and 3) Likert-type scale. It consists of eight items, as follows:

  1. (1).

    Sleepiness while sitting and reading.

  2. (2).

    Sleepiness while watching TV.

  3. (3).

    Sleepiness while sitting still in a community (theater, meeting, etc.).

  4. (4).

    Sleepiness when on a car ride without a break for an hour.

  5. (5).

    Sleepiness while lying down to rest for an afternoon.

  6. (6).

    Sleepiness while sitting and talking with a person.

  7. (7).

    Sleepiness while sitting calmly after a no-alcohol lunch.

  8. (8).

    Sleepiness when stopping for a few minutes due to traffic while driving a car.

Individuals with a total score of 11 and above are considered to have EDS [3].

A nightly sleep study was conducted in the sleep laboratory of otorhinolaryngology. All the polysomnographies were performed using Weinmann Sonnolab 2 equipment, including an electroencephalograph, an electrooculograph, a submental and bilateral tibial electromyograph, an electrocardiograph, a nasal pressure transducer, an oronasal thermistor for airflow, thoracic and abdominal respiratory impedance plethysmography belts, and a pulse oximeter (SpO2).

All the sleep studies were evaluated and scored by a board-certified sleep medicine physician using the standard the 2012 American Academy of Sleep Medicine criteria for scoring sleep, arousal, and respiratory events. Based on the AHI in the polysomnography results, the patients were divided into four groups according to the severity of their illness: Group 1: patients where OSAS was not detected (patients with a less than 5 AHI); Group 2: patients with mildly obstructive sleep apnea (patients with a 5–20 AHI); Group 3: patients with moderate obstructive sleep apnea (patients with a 21–40 AHI); and Group 4: patients with severe obstructive sleep apnea (patients with a greater than 40 AHI).

The neck circumference (cm) was taken using a non-stretch tape measure. It was taken on a horizontal plane, just below the thyroid cartilage, while paying attention to the same level of anterior-posterior tape measure. Meanwhile, the patient was asked to stand upright and to look ahead. The height and body weight data of the patients were obtained verbally from them, and their body mass index (BMI) was calculated by dividing their body weight (kg) by the square of their height (m).

Statistical analyses were done by using the statistical package for the social sciences (SPSS) 22.0 program. Both patient-administered ESS (ESSp) and doctor-administered ESS (ESSd) found to be normally distributed, parametric tests (t test and Pearson’s correlation were done as appropriate). Also, linear regression was used to assess the relationship between them. Data were considered statistically significant if the value was less than 0.05.

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