Omobomi Olabimpe, Batool-Anwar Salma, Quan Stuart F
Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Asthma and Airways Research Center, University of Arizona College of Medicine, Tucson, AZ.
Sleep Vigil. 2019 Dec;3(2):131-138. doi: 10.1007/s41782-019-00068-2. Epub 2019 Jun 19.
The decision to treat mild obstructive sleep apnea (OSA) often hinges on the presence of subjective daytime sleepiness. This study was done to identify clinical and polysomnographic features which correlate with subjective sleepiness in mild OSA.
Utilizing data from the Apnea Positive Pressure Long-term Efficacy Study, 199 participants with mild OSA were identified. Participants were grouped as "sleepy" or "non-sleepy" based on their responses to a question regarding excessive daytime sleepiness, and Epworth Sleepiness Scores. We compared demographic, clinical and baseline polysomnographic data between the groups.
The prevalence of subjective sleepiness was 74.4%. The sleepy group was younger (46.1 ± 12.6 vs. 53.3 ± 13.1 years, p=0.001), reported lower quality of life (4.5 ± 0.69 vs. 4.9 ± 0.61, p=0.0002), had higher depression scores (5.4 ± 4.7 vs. 3.1 ± 3.5, p=0.003) and reported more naps per week (2.6 ± 2.9 vs. 1.3 ± 1.9, p=0.01). Total sleep time and sleep efficiency were notably higher in the sleepy (254.2 ± 106 vs. 220.4 ± 114 min, p=0.08) and (80.2 ± 12.6 vs. 75.7 ± 14.9 %, p=0.06), approaching statistical significance. The non-sleepy group had slightly higher apnea hypopnea index (AHI: 12.2 ± 1.5 vs. 11.2 ± 2.4 events/hour, p=0.01) and worse desaturation indices.
Subjective sleepiness in mild OSA is associated with younger age, worsened mood and quality of life. This study suggests that evidence of increased sleep drive on polysomnography may correlate with subjective sleepiness in mild OSA.
轻度阻塞性睡眠呼吸暂停（OSA）的治疗决策通常取决于主观日间嗜睡的存在情况。本研究旨在确定与轻度OSA主观嗜睡相关的临床和多导睡眠图特征。
利用来自呼吸暂停正压长期疗效研究的数据，确定了199名轻度OSA参与者。根据参与者对有关日间过度嗜睡问题的回答以及爱泼华嗜睡量表评分，将他们分为“嗜睡”或“非嗜睡”组。我们比较了两组之间的人口统计学、临床和基线多导睡眠图数据。
主观嗜睡的患病率为74.4%。嗜睡组更年轻（46.1±12.6岁对53.3±13.1岁，p=0.001），报告的生活质量较低（4.5±0.69对4.9±0.61，p=0.0002），抑郁评分较高（5.4±4.7对3.1±3.5，p=0.003），且每周报告的小睡次数更多（2.6±2.9次对1.3±1.9次，p=0.01）。嗜睡组的总睡眠时间和睡眠效率明显更高（分别为254.2±106分钟对220.4±114分钟，p=0.08；80.2±12.6%对75.7±14.9%，p=0.06），接近统计学意义。非嗜睡组的呼吸暂停低通气指数（AHI）略高（12.2±1.5次/小时对11.2±2.4次/小时，p=0.01），且低氧饱和度指数更差。
轻度OSA中的主观嗜睡与年轻、情绪恶化和生活质量下降有关。本研究表明，多导睡眠图上睡眠驱动力增加的证据可能与轻度OSA中的主观嗜睡相关。
