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This chapter reviews the psychometric properties, validation, and strengths and weaknesses of the most common measurement tools used for the subjective evaluation of sleepiness. Subjective measures of sleepiness described in the chapter include visual analogue scales (VAS), Stanford sleepiness scale (SSS), Karolinska sleepiness scale (KSS), Epworth sleepiness scale (ESS) pediatric sleep questionnaire, sleepiness subscale (PSQ-SS) and pediatric daytime sleepiness scale (PDSS). Children present with a variety of sleep disorders associated with excessive sleepiness. Subjective sleepiness is critical as it is often the initial symptom of underlying sleep pathology, and a major presenting complaint that clinicians must understand and address. More work is needed on potential cultural and racial differences in subjective sleepiness and in relation to specific types of measurement. It has been shown that subjective sleepiness is accompanied by EEG changes including selective slowing of specific frequency bands.
The aim of the present study is to analyze how well physiological
measures of sleepiness derived from pupillography and the Multiple
Sleep Latency Test correlate with a subjective measure, the
Stanford Sleepiness Scale (SSS) score. The results are based
on data from 12 healthy participants, who underwent these tests
every 2 hr from 7:00 a.m. until 11:00 p.m. Sleep latencies were
correlated with four different variables derived from pupillography
and the SSS score. The results indicate that the physiologically
based variables correspond very well. This is reflected by similar
patterns of time-of-day variations, a good agreement at the
group level, and correlations at the individual level, whereas
the SSS shows a quite different pattern of variation. The two
physiological measures of sleepiness seem to reflect the same
aspect of the level of tonic central nervous activation, which
is not correlated with the subjective feeling of sleepiness.
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