What is the best measure of daytime sleepiness in adults with heart failure?

Purpose: To identify the best screening measure of daytime sleepiness inadults with heart failure (HF).Data sources: A total of 280 adults with HF completed the Epworth Sleepi-ness Scale, the Stanford Sleepiness Scale, and a single Likert item measuringdaytime sleepiness. The sensitivity and specificity of these self-report measureswere assessed in relation to a measure of daytime dysfunction from poor sleepquality.Conclusions: Only 16% of the sample reported significant daytime dysfunc-tion because of poor sleep quality. Those reporting daytime dysfunction werelikely to be younger (p < .001), to be unmarried (p = .002), to have New YorkHeart Association (NYHA) functional class IV HF (p = .015), and to report lowincome (p = .006) and fewer hours of sleep (p = .015). The measure of daytimesleepiness that was most sensitive to daytime dysfunction was a single Likertitem measured on a 10-point (1–10) scale. Patients with a score ≥4were2.4times more likely to have daytime dysfunction than those with a score < 4.Implications for practice: Complaints of daytime dysfunction because ofpoor sleep are not common in adults with HF. Routine use of a single ques-tion about daytime sleepiness can help nurse practitioners to identify those HFpatients with significant sleep issues that may require further screening.