Spicuzza Lucia, Mancuso Salvatore, Campisi Raffaele, Vancheri Carlo
Dipartimento di Medicina Clinica e Sperimentale, UO Pneumologia, Azienda Policlinico-OVE, University of Catania, Via S. Sofia, 95123, Catania, Italy.
J Patient Rep Outcomes. 2022 May 8;6(1):46. doi: 10.1186/s41687-022-00454-x.
The first wave of the COVID-19 pandemic has produced remarkable effects on the sleep quality and mental status of the general population and more dramatic effects on patients with chronic illness. Patients with obstructive sleep apnea (OSA), already suffering from disordered sleep, might be more susceptible to the effect of the pandemic on their sleep quality and mental health. We therefore performed a case-control study to compare sleep quality, depression and anxiety symptoms reported by patients with severe OSA and age-matched healthy subjects during the first wave of the COVID-19. In June-July 2020 we enrolled a total of 222 patients with severe OSA, all treated with continuous positive airway pressure, and 164 healthy controls. Self-reported sleep quality was assessed using the Pittsburg Sleep Quality Index (PSQI). Symptoms of depression were assessed using the Patient Health Questionnaire module 9 (PHQ-9), while the specific "Coronavirus Anxiety Scale" (CAS) evaluated the level of anxiety.
Patients with OSA (61% males, 65 ± 9.6 years old, BMI 30.5 ± 3.6) and healthy controls had similar characteristics except for BMI slightly lower in controls. The perceived quality of sleep, referred to the pre-pandemic period, was significantly worse in patients with OSA than in controls. During the pandemic the rate of reported sleep disturbance increased from 54 to 66% in patients with OSA and from 29 to 40% in controls. A high percentage of patients and controls reported symptoms of depression (61% OSA and 65% controls), whereas lower levels of anxiety, similar in the two groups, were observed. In patients with OSA the PSQI score significantly positively correlated with the PHQ-9 score (r = 0.81) and the CAS score (r = 0.65).
The rate of reported sleep disturbance in patients with OSA during the first wave of the COVID-19 pandemic is one of the highest evidenced in literature so far. As for the general population, in these patients there is a strict link between the perceived sleep quality and the psychological distress caused by the pandemic. A further deterioration of sleep quality is a fearsome event in the life of these patients who face life-long sleep problems.
新冠疫情的第一波对普通人群的睡眠质量和精神状态产生了显著影响，对慢性病患者的影响更为显著。阻塞性睡眠呼吸暂停（OSA）患者本来就存在睡眠紊乱问题，可能更容易受到疫情对其睡眠质量和心理健康的影响。因此，我们进行了一项病例对照研究，以比较新冠疫情第一波期间重度OSA患者和年龄匹配的健康受试者报告的睡眠质量、抑郁和焦虑症状。2020年6月至7月，我们共招募了222例重度OSA患者，均接受持续气道正压通气治疗，以及164名健康对照者。使用匹兹堡睡眠质量指数（PSQI）评估自我报告的睡眠质量。使用患者健康问卷模块9（PHQ - 9）评估抑郁症状，而特定的“冠状病毒焦虑量表”（CAS）评估焦虑水平。
OSA患者（61%为男性，65±9.6岁，BMI 30.5±3.6）和健康对照者具有相似特征，只是对照组的BMI略低。与疫情前相比，OSA患者感知到的睡眠质量明显比对照组差。疫情期间，OSA患者报告的睡眠障碍发生率从54%增加到66%，对照组从29%增加到40%。高比例的患者和对照者报告有抑郁症状（OSA患者为61%，对照者为65%），而两组焦虑水平较低且相似。在OSA患者中，PSQI评分与PHQ - 9评分（r = 0.81）和CAS评分（r = 0.65）显著正相关。
新冠疫情第一波期间，OSA患者报告的睡眠障碍发生率是迄今为止文献中记载最高的之一。与普通人群一样，这些患者感知到的睡眠质量与疫情引起的心理困扰之间存在紧密联系。睡眠质量的进一步恶化对这些面临终身睡眠问题的患者来说是一件可怕的事情。
