Yasin Rashidah, Muntham Dittapol, Chirakalwasan Naricha
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Sleep Breath. 2016 Dec;20(4):1137-1144. doi: 10.1007/s11325-016-1380-6. Epub 2016 Aug 17.
Sleepiness and tiredness are common complaints among young doctors. Sleep deprivation is believed to be the main culprit. However, we believe that there may be other sleep disorders which may contribute to these symptoms such as occult obstructive sleep apnea (OSA).
A prospective cross-sectional study was performed among young doctors less than 40 years old, working at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, and Hospital Kuala Lumpur, Kuala Lumpur, Malaysia, using questionnaires and home sleep apnea testing (Apnealink™Plus). The primary objective of this study was to evaluate the prevalence of OSA (apnea-hypopnea index (AHI) ≥5). The secondary objectives were to evaluate the prevalence of obstructive sleep apnea syndrome (OSAS) defined by AHI ≥5 + excessive daytime sleepiness (EDS), sleep deprivation (the difference of weekend (non-workdays) and weekday (workdays) wake-up time of at least 2 h), EDS (Epworth Sleepiness Scale score ≥10), tiredness, and perception of inadequate sleep as well as to identify their predictors.
Total of 52 subjects completed the study. Mean age and mean body mass index (BMI) were 31.3 ± 4 and 23.3 ± 3.6, respectively. The prevalence of OSA and OSAS were 40.4 and 5.8 %, respectively. One third of OSA subjects were at least moderate OSA. Prevalence of sleep deprivation, EDS, tiredness, and perception of inadequate sleep were 44.2, 15.4, 65.4, and 61.5 %, respectively. History of snoring, being male, and perception of inadequate sleep were significant predictors for OSA with the odds ratio of 34.5 (p = 0.016, 95 % CI = 1.92-619.15), 18.8 (p = 0.001, 95 % CI = 3.10-113.41), and 7.4 (p = 0.037, 95 % CI = 1.13-48.30), respectively. Only observed apnea was a significant predictor for OSAS with odds ratio of 30.7 (p = 0.012, 95 % CI = 2.12-442.6). Number of naps per week was a significant predictor for EDS with the odds ratio of 1.78 (p = 0.007, 95 % CI = 1.17-2.71). OSA and total number of call days per month were significant predictors for tiredness with the odds ratio of 4.8 (p = 0.036, 95 % CI = 1.11-20.72) and 1.3 (p = 0.050, 95 % CI = 1.0004-1.61), respectively. OSA was the only significant predictor for perception of inadequate sleep with the odd ratios of 4.5 (p = 0.022, 95 % CI = 1.24-16.59).
Our results demonstrated relatively high prevalence of OSA and OSAS among young doctors. Snoring, being male, and perception of inadequate sleep were significant predictors for OSA. Observed apnea was a significant predictor for OSAS. OSA was a significant predictor for tiredness and perception of inadequate sleep.
嗜睡和疲劳是年轻医生常见的主诉。睡眠剥夺被认为是主要原因。然而,我们认为可能存在其他睡眠障碍也会导致这些症状,如隐匿性阻塞性睡眠呼吸暂停(OSA)。
对泰国曼谷朱拉隆功国王纪念医院和马来西亚吉隆坡吉隆坡医院年龄小于40岁的年轻医生进行了一项前瞻性横断面研究,采用问卷调查和家庭睡眠呼吸暂停检测(Apnealink™Plus)。本研究的主要目的是评估OSA的患病率(呼吸暂停低通气指数(AHI)≥5)。次要目的是评估由AHI≥5+日间过度嗜睡(EDS)定义的阻塞性睡眠呼吸暂停综合征(OSAS)的患病率、睡眠剥夺(周末(非工作日)和工作日(工作日)起床时间相差至少2小时)、EDS(爱泼华嗜睡量表评分≥10)、疲劳以及睡眠不足的感知,并确定其预测因素。
共有52名受试者完成了研究。平均年龄和平均体重指数(BMI)分别为31.3±4和23.3±3.6。OSA和OSAS的患病率分别为40.4%和5.8%。三分之一的OSA受试者至少为中度OSA。睡眠剥夺、EDS、疲劳和睡眠不足感知的患病率分别为44.2%、15.4%、65.4%和61.5%。打鼾史、男性以及睡眠不足的感知是OSA的显著预测因素,比值比分别为34.5(p=0.016,95%CI=1.92-619.15)、18.8(p=0.001,95%CI=3.10-113.41)和7.4(p=0.037,95%CI=1.13-48.30)。仅观察到的呼吸暂停是OSAS的显著预测因素,比值比为30.7(p=0.012,95%CI=2.12-442.6)。每周小睡次数是EDS的显著预测因素,比值比为1.78(p=0.007,95%CI=1.17-2.71)。OSA和每月总值班天数是疲劳的显著预测因素,比值比分别为4.8(p=0.036,95%CI=1.11-20.72)和1.3(p=0.050,95%CI=1.0004-1.61)。OSA是睡眠不足感知的唯一显著预测因素,比值比为4.5(p=0.022,95%CI=1.24-16.59)。
我们的结果表明年轻医生中OSA和OSAS的患病率相对较高。打鼾、男性以及睡眠不足的感知是OSA的显著预测因素。观察到的呼吸暂停是OSAS的显著预测因素。OSA是疲劳和睡眠不足感知的显著预测因素。