Steffen Armin, Baptista Peter, Ebner Eva-Maria, Jeschke Stephanie, König Inke R, Bruchhage Karl-Ludwig
Department of Otorhinolaryngology University of Lübeck Lübeck Germany.
Department of Otorhinolaryngology Clínica Universidad de Navarra Pamplona Spain.
Laryngoscope Investig Otolaryngol. 2022 May 24;7(3):877-884. doi: 10.1002/lio2.761. eCollection 2022 Jun.
Comorbid insomnia may impact outcomes of patients with obstructive sleep apnea (OSA) receiving hypoglossal nerve stimulation with respiratory sensing (HNS) therapy. To examine whether the presence of insomnia measured using the Insomnia Severity Index (ISI) is associated with patient-reported outcomes and objective OSA measures in patients receiving HNS therapy.
In this retrospective chart review, patients with an HNS implant and ISI score at follow-up assessment were categorized as having moderate/severe insomnia or no/subthreshold insomnia. OSA-related data (Apnea Hypopnea Index, AHI; Oxygen Desaturation Index, ODI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), and overall patient satisfaction was compared between these patient categories. Correlations between ISI scores and each of these variables were examined.
Of the 132 patients, 26% had moderate/severe insomnia at follow-up assessment. ESS and FOSQ scores were worse in the insomnia group at baseline, follow-up, and in the change from baseline, but AHI and ODI scores did not differ between patients with and without insomnia. Frequency of overall satisfaction at follow-up was lower in the insomnia group (58.8% vs. 92.8% with no insomnia, < .001). Patients with insomnia were more likely to have depression (56% vs. 27% without insomnia, < .002).
Insomnia is associated with worse patient-reported outcomes of daytime sleepiness and sleep-related quality of life in patients with OSA receiving HNS therapy. Depression is more prevalent in patients with comorbid insomnia. The ISI may help physicians to address comorbid insomnia and achieve high patient satisfaction and adherence to HNS therapy.
共病性失眠可能会影响接受舌下神经刺激伴呼吸感应（HNS）治疗的阻塞性睡眠呼吸暂停（OSA）患者的治疗效果。旨在探讨使用失眠严重程度指数（ISI）测量的失眠情况是否与接受HNS治疗患者的自我报告结局及客观OSA指标相关。
在这项回顾性病历审查中，将在随访评估时有HNS植入且有ISI评分的患者分为中度/重度失眠或无/亚阈值失眠。比较这些患者类别之间的OSA相关数据（呼吸暂停低通气指数，AHI；氧饱和度下降指数，ODI）、爱泼华嗜睡量表（ESS）、睡眠问卷功能结局（FOSQ）以及患者总体满意度。检查ISI评分与上述各变量之间的相关性。
132例患者中，26%在随访评估时有中度/重度失眠。失眠组在基线、随访时以及与基线相比的变化中，ESS和FOSQ评分更差，但有失眠和无失眠患者的AHI和ODI评分无差异。失眠组随访时总体满意度频率较低（58.8% vs无失眠组的92.8%，<0.001）。失眠患者更易患抑郁症（56% vs无失眠患者的27%，<0.002）。
失眠与接受HNS治疗的OSA患者自我报告的日间嗜睡和睡眠相关生活质量较差的结局相关。共病性失眠患者中抑郁症更为普遍。ISI可能有助于医生处理共病性失眠并实现高患者满意度和对HNS治疗的依从性。
4级。
