Lee Min-hwan, Lee Sang-Ahm, Lee Gha-hyun, Ryu Ho-Sung, Chung Seockhoon, Chung Yoo-Sam, Kim Woo Sung
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
Sleep Breath. 2014 Mar;18(1):111-7. doi: 10.1007/s11325-013-0856-x. Epub 2013 May 9.
This study investigated gender differences in the effect of comorbid insomnia symptom on depression, anxiety, fatigue, daytime sleepiness, and quality of life in patients with obstructive sleep apnea. There are gender differences in the presentation of obstructive sleep apnea. However, the influence of gender on the presentation of comorbid insomnia symptom and obstructive sleep apnea is not known.
Allparticipantsperformed overnightpolysomnography and completed a battery of questionnaires including Beck Depression Inventory, State-Trait Anxiety Inventory, Multidimensional Fatigue Inventory, Epworth Sleepiness Scale, and Short Form-36 Health Survey. Insomnia symptom was defined as present if a patient had any insomnia complaints longer than 1 month and at least one time per week.
Six hundred fifty-five adult patients with obstructive sleep apnea were enrolled; 233 (35.5 %) reported comorbid insomnia symptom with obstructive sleep apnea. The severity of obstructive sleep apnea was not related to comorbid insomnia symptom. Based on linear regression, women had higher depression, fatigue, and daytime sleepiness and lower health-related quality of life than men (all, p<0.05). The presence of insomnia symptom had negative effects on fatigue (p=0.005) and quality of life only (p=0.015) in men but not in women when taking gender-by-insomnia interaction into consideration. There were significant differences in polysomnography-based sleep architecture between the obstructive sleep apnea-only and obstructive sleep apnea-insomnia groups, but only in the subgroup of men.
Men are more prone to the negative impact of comorbid insomnia symptom and obstructive sleep apnea on their level of fatigue and quality of life than women.
本研究调查了共病失眠症状对阻塞性睡眠呼吸暂停患者的抑郁、焦虑、疲劳、日间嗜睡和生活质量影响中的性别差异。阻塞性睡眠呼吸暂停的表现存在性别差异。然而，性别对共病失眠症状和阻塞性睡眠呼吸暂停表现的影响尚不清楚。
所有参与者均进行了整夜多导睡眠图检查，并完成了一系列问卷，包括贝克抑郁量表、状态-特质焦虑量表、多维疲劳量表、爱泼华嗜睡量表和简明健康调查36项量表。如果患者有任何持续超过1个月且每周至少一次的失眠主诉，则定义为存在失眠症状。
纳入了655例成年阻塞性睡眠呼吸暂停患者；233例（35.5%）报告有阻塞性睡眠呼吸暂停合并失眠症状。阻塞性睡眠呼吸暂停的严重程度与共病失眠症状无关。基于线性回归分析，女性比男性有更高的抑郁、疲劳和日间嗜睡水平，以及更低的健康相关生活质量（均p<0.05）。考虑性别与失眠的交互作用时，失眠症状的存在仅对男性的疲劳（p=0.005）和生活质量（p=0.015）有负面影响，对女性则无影响。仅患有阻塞性睡眠呼吸暂停的组和阻塞性睡眠呼吸暂停合并失眠的组之间，基于多导睡眠图的睡眠结构存在显著差异，但仅在男性亚组中。
与女性相比，男性更容易受到共病失眠症状和阻塞性睡眠呼吸暂停对其疲劳水平和生活质量的负面影响。
