Health Services Research & Development, VA San Diego Healthcare System, San Diego, CA 92161, USA.
Sleep Med. 2011 Oct;12(9):832-7. doi: 10.1016/j.sleep.2011.07.004. Epub 2011 Oct 20.
OBJECTIVES OR BACKGROUND: Obstructive Sleep Apnea (OSA) is characterized by partial or complete cessation of breath during sleep. OSA is associated with increased cardiovascular risk as well as psychosocial complications such as daytime somnolence, depression, and fatigue. The goal of the present study was to better understand fatigue in OSA by examining self-reported sleep quality, depressive symptoms, excessive daytime sleepiness, and OSA severity in a group of newly diagnosed OSA patients.
Two hundred and forty newly diagnosed OSA patients enrolled in the study. Participants completed several questionnaires at baseline.
Depressive symptoms accounted for 15% of variance in fatigue beyond that of demographics and OSA severity (p<0.001). Self-reported sleep quality accounted for 11% of variance beyond that of depressive symptoms (p<0.001). The total model accounted for 48% of the variance in fatigue. Post hoc analysis found that the total model accounted for only 14% of the variance in sleepiness (as measured by the Epworth Sleepiness Scale).
The current study confirms the findings of previous OSA studies, which found depressive symptoms have a greater association with fatigue than OSA disease severity variables. This study extends those findings by showing that self-reported sleep quality is independently associated with fatigue, even after taking into account demographic, comorbid conditions, OSA disease severity, sleepiness, and depressive symptoms. The role of sleep quality as an independent contributor to daytime fatigue in OSA may be under appreciated. Sleep quality should be closely followed in the clinical management of OSA.
阻塞性睡眠呼吸暂停（OSA）的特征是睡眠期间呼吸部分或完全停止。OSA 与心血管风险增加以及心理社会并发症相关，如白天嗜睡、抑郁和疲劳。本研究的目的是通过检查一组新诊断的 OSA 患者的自我报告的睡眠质量、抑郁症状、白天过度嗜睡和 OSA 严重程度，更好地了解 OSA 中的疲劳。
240 名新诊断的 OSA 患者参加了这项研究。参与者在基线时完成了几个问卷。
抑郁症状占疲劳的 15%，超过了人口统计学和 OSA 严重程度的差异（p<0.001）。自我报告的睡眠质量占抑郁症状差异的 11%（p<0.001）。总模型占疲劳方差的 48%。事后分析发现，总模型仅占嗜睡（以 Epworth 嗜睡量表测量）方差的 14%。
本研究证实了先前 OSA 研究的发现，即抑郁症状与疲劳的相关性大于 OSA 疾病严重程度变量。本研究通过显示自我报告的睡眠质量与疲劳独立相关，即使考虑到人口统计学、合并症、OSA 疾病严重程度、嗜睡和抑郁症状，进一步证实了这一发现。睡眠质量作为 OSA 白天疲劳的独立因素的作用可能被低估了。在 OSA 的临床管理中，应密切关注睡眠质量。
