Τίτλος:
The Complex Interaction Between the Major Sleep Symptoms, the Severity of Obstructive Sleep Apnea, and Sleep Quality
Περίληψη:
Introduction: Little information exists in the general population whether clinical presentation phenotypes of obstructive sleep apnea (OSA) differ in terms of sleep quality and comorbidities. Aim: The purpose of our study was to assess possible differences between symptomatic and asymptomatic OSA patients concerning syndrome's severity, patients' sleep quality, and comorbidities. Subjects and methods: First, in a nationwide, stratified, epidemiological survey, 4,118 Cypriot adult participants were interviewed about sleep habits and complaints. In the second stage of the survey, 264 randomly selected adults underwent a type III sleep study for possible OSA. Additionally, they completed the Greek version of Pittsburgh Sleep Quality Index (Gr-PSQI), Epworth Sleepiness Scale (ESS), Athens Insomnia Scale (AIS), and Hospital Anxiety and Depression Scale (HADS). Results: From 264 enrolled participants, 155 individuals (40 females and 115 males) were first diagnosed with OSA. Among these 155 patients, 34% had ESS ≥ 10 and 49% AIS ≥ 6. One or both symptoms present categorized the individual as symptomatic (60%) and neither major symptom as asymptomatic (40%). There were no significant statistical differences (SSDs) between the two groups (symptomatic–asymptomatic) with regard to anthropometrics [age or gender; neck, abdomen, and hip circumferences; and body mass index (BMI)]. The two groups had no differences in OSA severity—as expressed by apnea–hypopnea index (AHI), oxygen desaturation index (ODI), and mean oxyhemoglobin saturation (SaO2)—and in cardiometabolic comorbidities. Symptomatic patients expressed anxiety and depression more often than asymptomatics (p < 0.001) and had poorer subjective sleep quality (Gr-PSQI, p < 0.001). According to PSQI questionnaire, there were no SSDs regarding hours in bed and the use of sleep medications, but there were significant differences in the subjective perception of sleep quality (p < 0.001), sleep efficiency (p < 0.001), duration of sleep (p = 0.001), sleep latency (p = 0.007), daytime dysfunction (p < 0.001), and finally sleep disturbances (p < 0.001). Conclusion: According to our data, OSA patients reporting insomnia-like symptoms and/or sleepiness do not represent a more severe phenotype, by the classic definition of OSA, but their subjective sleep quality is compromised, causing a vicious cycle of anxiety or depression. © Copyright © 2021 Frangopoulos, Zannetos, Nicolaou, Economou, Adamide, Georgiou, Nikolaidis, Rosemann, Knechtle and Trakada.
Συγγραφείς:
Frangopoulos, F.
Zannetos, S.
Nicolaou, I.
Economou, N.-T.
Adamide, T.
Georgiou, A.
Nikolaidis, P.T.
Rosemann, T.
Knechtle, B.
Trakada, G.
Λέξεις-κλειδιά:
abdominal circumference; adult; age; aged; anthropometric parameters; anxiety disorder; apnea hypopnea index; Article; Athens Insomnia Scale; body mass; cardiometabolic risk; cohort analysis; comorbidity; controlled study; daytime somnolence; depression; disease association; disease severity; epidemiological data; Epworth sleepiness scale; female; gender; health survey; hip circumference; Hospital Anxiety and Depression Scale; human; insomnia; interview; major clinical study; male; medication therapy management; middle aged; neck circumference; oxygen desaturation index; oxygen dissociation curve; oxygen saturation; Pittsburgh Sleep Quality Index; sleep disorder; sleep disorder assessment; sleep disordered breathing; sleep efficiency; sleep latency; sleep pattern; sleep quality; sleep time; symptom; symptom assessment; very elderly; young adult
