Kazemeini Elahe, Braem Marc J, Moorkens Greta, Balina Sowjanya, Kastoer Chloé, Op de Beeck Sara, Vanderveken Olivier M, Dieltjens Marijke
Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium.
Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium.
J Clin Sleep Med. 2019 Apr 15;15(4):623-628. doi: 10.5664/jcsm.7728.
The objective of this study was to measure fatigue and hypersomnolence in patients with obstructive sleep apnea (OSA) treated with a mandibular advancement device (MAD), using Epworth Sleepiness Scale (ESS) for hypersomnolence and Checklist Individual Strength questionnaire (CIS20R) for fatigue.
This was a single-center, prospective cohort study. A total of 58 patients with OSA filled out ESS and CIS20R questionnaires at baseline and after 3 months of MAD treatment. A total of 39 full datasets were collected. Statistical analysis for reliability of the questionnaires, comparison between baseline and 3-month follow-up, correlation between the changes in the values of the two questionnaires, and changes in apnea-hypopnea index (AHI) were performed.
CIS20R showed excellent reliability in this patient group at baseline and 3-month follow-up (Cronbach α = .97), ESS showed a marginally good reliability (Cronbach α = .82). The CIS20R (82/140) expressed high levels of fatigue at baseline, and ESS showed a normal level of daytime sleepiness. AHI, ESS, and CIS20R were significantly reduced under MAD treatment. A significant correlation between ESS and CIS20R was observed. No significant correlation between any of the questionnaires and the change in AHI was found.
The CIS20R questionnaire results showed a high level of fatigue in the patients with OSA, and the questionnaire can be used to evaluate changes in fatigue due to MAD treatment after 3 months. The ESS failed to show similar characteristics. Therefore, a combination of ESS for hypersomnolence with CIS20R for fatigue is proposed for the follow-up of patients with OSA treated with MAD.
本研究的目的是使用爱泼沃斯思睡量表（ESS）评估嗜睡情况，以及使用个人力量清单问卷（CIS20R）评估疲劳情况，来测量接受下颌前移装置（MAD）治疗的阻塞性睡眠呼吸暂停（OSA）患者的疲劳和嗜睡程度。
这是一项单中心前瞻性队列研究。共有58例OSA患者在基线时以及MAD治疗3个月后填写了ESS和CIS20R问卷。共收集到39份完整数据集。对问卷的可靠性进行了统计分析，比较了基线和3个月随访之间的情况，分析了两份问卷数值变化之间的相关性，以及呼吸暂停低通气指数（AHI）的变化情况。
CIS20R在该患者组的基线和3个月随访时显示出极佳的可靠性（克朗巴哈α系数 = 0.97），ESS显示出勉强良好的可靠性（克朗巴哈α系数 = 0.82）。CIS20R（82/140）在基线时表现出较高的疲劳水平，而ESS显示出正常水平的日间嗜睡。在MAD治疗下，AHI、ESS和CIS20R均显著降低。观察到ESS和CIS20R之间存在显著相关性。未发现任何问卷与AHI变化之间存在显著相关性。
CIS20R问卷结果显示OSA患者存在较高水平的疲劳，该问卷可用于评估MAD治疗3个月后疲劳情况的变化。ESS未能显示出类似特征。因此，建议将评估嗜睡的ESS与评估疲劳的CIS20R联合用于接受MAD治疗的OSA患者的随访。
