Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea,
Eur Neurol. 2019;81(3-4):190-196. doi: 10.1159/000502003. Epub 2019 Jul 23.
Both obstructive sleep apnea (OSA) and obesity are associated with poor sleep quality. However, there have been no studies investigating sleep quality in OSA patients with obesity. The aims of this study were to (1) evaluate the sleep quality in OSA patients with obesity and (2) identify the parameters most related to sleep quality in OSA patients with obesity.
Of the patients with polysomnography (PSG), OSA patients with obesity (body mass index [BMI] ≥25) were enrolled and then divided into 2 groups based on the Pittsburg Sleep Questionnaire Index (PSQI): patients with good sleep quality (PSQI ≤5, good sleepers) and those with poor sleep quality (PSQI >5, poor sleepers). In addition, we enrolled OSA patients without obesity as a disease control group.
Eighty-two OSA patients with obesity met the inclusion criteria (28 were good sleepers, whereas 54 were poor sleepers). We found that the BMI of the poor sleepers was significantly higher than that of the good sleepers, whereas the N-stage sleep ratio of good sleepers was higher than that of poor sleepers. Logistic -regression analysis also showed that a high BMI and low -N-stage sleep ratio were independently associated with poor sleep quality. In addition, BMI and N-stage sleep ratio were significantly correlated with PSQI. However, in 56 OSA patients (n = 56) without obesity, there were no differences of demographic/clinical characteristics and PSG parameters between the good (n = 18) and poor sleepers (n = 38).
About two-thirds of OSA patients with obesity show poor sleep quality. The sleep quality of these patients was more affected by the severity of obesity, but not the severity of OSA. Thus, we recommend weight loss in OSA patients with obesity to improve sleep quality as well as the severity of OSA.
阻塞性睡眠呼吸暂停（OSA）和肥胖均与睡眠质量差有关。然而，目前尚无研究调查肥胖合并 OSA 患者的睡眠质量。本研究的目的是：（1）评估肥胖合并 OSA 患者的睡眠质量，（2）确定肥胖合并 OSA 患者中与睡眠质量最相关的参数。
从接受多导睡眠图（PSG）检查的患者中，选取肥胖合并 OSA（体重指数 [BMI] ≥25）患者，并根据匹兹堡睡眠质量指数（PSQI）将其分为 2 组：睡眠质量良好（PSQI≤5，睡眠良好者）和睡眠质量差（PSQI＞5，睡眠差者）。此外，我们还选取了肥胖合并 OSA 患者作为疾病对照组。
符合纳入标准的肥胖合并 OSA 患者有 82 例（28 例为睡眠良好者，54 例为睡眠差者）。我们发现，睡眠差者的 BMI 显著高于睡眠良好者，而睡眠良好者的 N 期睡眠比例高于睡眠差者。Logistic 回归分析还显示，高 BMI 和低 N 期睡眠比例与睡眠质量差独立相关。此外，BMI 和 N 期睡眠比例与 PSQI 显著相关。然而，在 56 例（n=56）无肥胖的 OSA 患者中，睡眠良好者（n=18）和睡眠差者（n=38）之间的人口统计学/临床特征和 PSG 参数无差异。
大约三分之二的肥胖合并 OSA 患者表现出睡眠质量差。这些患者的睡眠质量受肥胖严重程度的影响更大，但不受 OSA 严重程度的影响。因此，我们建议肥胖合并 OSA 患者减轻体重，以改善睡眠质量和 OSA 严重程度。
