The Top End Sleepiness Scale (TESS): A New Tool to Assess Subjective Daytime Sleepiness Among Indigenous Australian Adults

• Main Authors: Benn E, Wirth H, Short T, Howarth T, Heraganahally SS
• Format: Article in Journal/Newspaper
• Language: English
• Published: Dove Medical Press 2021
• Subjects: first nations; aboriginal; epworth sleepiness scale; indigenous; sleepiness scale; subjective daytime sleepiness; Psychiatry; RC435-571; Neurophysiology and neuropsychology; QP351-495; Flinders; First Nations
• Online Access: https://doaj.org/article/dfe3d018342a43c9af1d96886f621000

Edmund Benn,1 Hugh Wirth,1 Teagan Short,1 Timothy Howarth,2,3 Subash S Heraganahally1,3,4 1College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia; 2College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia; 3Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, Northern Territory, Australia; 4Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, AustraliaCorrespondence: Subash S HeraganahallyDepartment of Respiratory and Sleep Medicine, Royal Darwin Hospital, Tiwi, Darwin, NT, AustraliaTel [phone]Fax [phone]Email [e-mail]: To illustrate the utility of a newly developed culturally safe and clinically relevant subjective daytime sleepiness assessment tool “Top End Sleepiness Scale” (TESS) for use among Indigenous Australians.Patients and Methods: The TESS questionnaire consists of pictorial representations of 6 items representing daily activities that would induce daytime sleepiness specific for Indigenous Australians living in the regional and remote Australia. Consecutive adult Indigenous patients who consented to pilot the TESS questionnaire prior to undergoing a diagnostic polysomnography (PSG) at the Top End Health Service region, Northern Territory of Australia were assessed. The TESS questionnaire was evaluated for its correlation in predicting obstructive sleep apnea (OSA) according to apnea-hypopnea index.Results: Eighty-two patients were included. The majority (70%) had moderate to severe OSA (AHI ≥ 15). Patients were aged in their mid-40’s (45.47 95% CI (42.9, 48.05)) with a tendency to obesity (median BMI 33.67 IQR 30.86, 38.95) and a high prevalence of chronic conditions (72%) (hypertension, diabetes or heart disease). The TESS showed high internal consistency (Split half Spearman correlation=0.71, Cronbach’s α =0.81), and a cut-off value ≥ 3 resulted in sensitivity 84%, specificity 38%. Comparison of area under the curve ...