University of California, San Diego, California.
San Francisco VA Health Care System, San Francisco, California.
J Clin Sleep Med. 2019 Feb 15;15(2):235-243. doi: 10.5664/jcsm.7624.
Few population-based studies have explored how excessive sleepiness (ES) contributes to burden of illness among patients with obstructive sleep apnea (OSA).
This study utilized data from the annual, cross-sectional 2016 US National Health and Wellness Survey. Respondents self-reporting an OSA diagnosis were categorized as having ES (Epworth Sleepiness Scale [ESS] score ≥ 11) or not having ES (ESS score < 11). Comorbidities, health-related quality of life (HRQoL), and productivity were examined in three groups: OSA with ES (n = 731), OSA without ES (n = 1,452), and non-OSA controls (n = 86,961).
The OSA with ES group had significantly higher proportions of respondents reporting depression (62.4% versus 48.0%), gastroesophageal reflux disease (39.0% versus 29.4%), asthma (26.3% versus 20.7%), and angina (7.8% versus 6.7%) compared to the OSA without ES group ( < .05). After controlling for covariates, the OSA with ES group had significantly lower (worse) scores for mental component score (41.81 versus 45.65 versus 47.81), physical component score (46.62 versus 48.68 versus 51.36), and SF-6D (0.65 versus 0.69 versus 0.73) compared with OSA without ES and non-OSA controls (all < .001). The OSA with ES group had significantly higher (greater burden) mean rates of presenteeism (25.98% impairment versus 19.24% versus 14.75%), work impairment (29.41% versus 21.82% versus 16.85%), and activity impairment (31.09% versus 25.46% versus 19.93%) compared with OSA without ES and non-OSA controls (all < .01) after controlling for covariates.
OSA with ES is associated with higher prevalence of comorbidities, reduced HRQoL, and greater impairment in productivity compared to OSA without ES and compared to non-OSA controls.
很少有基于人群的研究探讨过度嗜睡(ES)如何增加阻塞性睡眠呼吸暂停(OSA)患者的疾病负担。
本研究利用了 2016 年美国国家健康与健康调查的年度横断面数据。自我报告 OSA 诊断的受访者被分为存在 ES(Epworth 睡眠量表[ESS]评分≥11)或不存在 ES(ESS 评分<11)。在三组中检查了合并症、健康相关生活质量(HRQoL)和生产力:OSA 伴 ES(n=731)、OSA 不伴 ES(n=1452)和非 OSA 对照组(n=86961)。
OSA 伴 ES 组报告抑郁(62.4%比 48.0%)、胃食管反流病(39.0%比 29.4%)、哮喘(26.3%比 20.7%)和心绞痛(7.8%比 6.7%)的患者比例明显高于 OSA 不伴 ES 组(<0.05)。在控制了协变量后,OSA 伴 ES 组的心理成分评分(41.81 比 45.65 比 47.81)、生理成分评分(46.62 比 48.68 比 51.36)和 SF-6D(0.65 比 0.69 比 0.73)明显较低(较差)与 OSA 不伴 ES 和非 OSA 对照组(均<0.001)。OSA 伴 ES 组的生产力损失率(25.98%的损伤率比 19.24%比 14.75%)、工作损伤率(29.41%比 21.82%比 16.85%)和活动损伤率(31.09%比 25.46%比 19.93%)明显高于 OSA 不伴 ES 和非 OSA 对照组(均<0.01),在控制了协变量后。
与 OSA 不伴 ES 和非 OSA 对照组相比,OSA 伴 ES 与更高的合并症患病率、更低的 HRQoL 和更大的生产力损失有关。