Carratú P, Karageorgiou G, Bonfitto P, Di Gioia G, Lacedonia D, Barbaro M P Foschino, Resta O
Institute of Respiratory Disease, Department of Clinical Methodology and Medical Surgery Technology, University of Bari, Italy.
Monaldi Arch Chest Dis. 2007 Mar;67(1):6-9. doi: 10.4081/monaldi.2007.503.
Patients with obstructive sleep apnoea syndrome (OSAS) suffer from disrupted sleep. Impaired nightly sleep leads to increase physical and mental fatigue. The effect of long term continuous positive airway pressure (CPAP) on mental fatigue in OSAS patients, assessed by Maastricht Questionnaire (MQ), has not been investigated yet.
In order to evaluate the role of CPAP in improving mental fatigue of patients with OSAS, we studied 35 patients (26 males, age < 65 years at the time of the diagnosis) affected by OSAS, established by polysomnography (PSG). Patients were divided into two groups; 19 subjects (15 males), who refused CPAP therapy, and 16 patients (11 males) well matched for sex, age, body mass index (BMI), neck circumference, duration of follow up, and severity of disease, who had been treated with CPAP for at least two years.
All patients had severe OSAS with Respiratory Disturbance Index (RDI), of 48 +/- 20.9 (range 22-90) and 61.48 +/- 18.6 (range 34-101) respectively, for group one (untreated patients) and group two (CPAP treatment). In addition, all patients had severe impairment of mental fatigue and of daytime sleepiness, demonstrated by high values of MQ score (32.17 +/- 15.33 and 37.36 +/- 12.4, respectively) and Epworth Sleepiness Scale (ESS) (14.21 +/- 4.77 and 15.06 +/- 6.07 respectively). There was no statistical significant difference in the group one at baseline and after follow-up, in terms of BMI, MQ score, ESS, and RDI. In the CPAP group (group two), the patients reported a significant improvement of the quality of their mental health (MQ 37.36 +/- 12.4 vs. 16.41 +/- 9.02; p < 0.0001) and sleepiness (ESS 15.06 +/- 6.07 vs. 4.13 +/- 3.93; p < 0.0001) with a stable BMI. There was significant correlation between the severity of sleep apnoea, expressed as RDI, and MQ at admission compared to at the end of follow-up (r = 0.4, p < 0.05).
This study demonstrates an evident deterioration of mental fatigue in patients with OSAS, directly correlated to the severity of nocturnal disorder breathing; however supports the hypothesis that long-term CPAP therapy significantly improves sleepiness and mental fatigue.
阻塞性睡眠呼吸暂停综合征（OSAS）患者存在睡眠中断问题。夜间睡眠受损会导致身心疲劳加剧。尚未研究通过马斯特里赫特问卷（MQ）评估长期持续气道正压通气（CPAP）对OSAS患者精神疲劳的影响。
为评估CPAP在改善OSAS患者精神疲劳中的作用，我们研究了35例经多导睡眠图（PSG）确诊为OSAS的患者（26例男性，诊断时年龄<65岁）。患者分为两组；19名受试者（15名男性）拒绝CPAP治疗，16例患者（11名男性）在性别、年龄、体重指数（BMI）、颈围、随访时间和疾病严重程度方面匹配良好，接受CPAP治疗至少两年。
所有患者均患有严重OSAS，第一组（未治疗患者）和第二组（CPAP治疗组）的呼吸紊乱指数（RDI）分别为48±20.9（范围22 - 90）和61.48±18.6（范围34 - 101）。此外，所有患者的精神疲劳和日间嗜睡均严重受损，通过MQ评分（分别为32.17±15.33和37.36±12.4）和爱泼沃斯嗜睡量表（ESS）（分别为14.21±4.77和15.06±6.07）的高值得以证明。第一组在基线和随访后，在BMI、MQ评分、ESS和RDI方面无统计学显著差异。在CPAP组（第二组）中，患者报告心理健康质量（MQ：37.36±12.4 vs. 16.41±9.02；p<0.0001）和嗜睡程度（ESS：15.06±6.07 vs. 4.13±3.93；p<0.0001）有显著改善，且BMI稳定。与随访结束时相比，入院时以RDI表示的睡眠呼吸暂停严重程度与MQ之间存在显著相关性（r = 0.4，p<0.05）。
本研究表明OSAS患者的精神疲劳明显恶化，与夜间呼吸紊乱的严重程度直接相关；然而支持了长期CPAP治疗可显著改善嗜睡和精神疲劳的假设。
