Gothi Dipti, Kumar Rahul, Anand Shweta, Patro Mahismita, Malhotra Nipun, Vaidya Sameer
Department of Pulmonary and Critical Care Medicine, ESI-PGIMSR, Basaidarapur, New Delhi, India.
Department of Pulmonary and Critical Care Medicine, Shwas Superspecialtiy Respiratory Centre, Indore, Madhya Pradesh, India.
Lung India. 2023 Jul-Aug;40(4):321-326. doi: 10.4103/lungindia.lungindia_28_23.
Restless leg syndrome (RLS) is common among patients with obstructive sleep apnoea (OSA) but the prognostic importance of this is not studied. We have called OSA and RLS coexistence as ComOSAR.
A prospective observational study was done on patients referred for polysomnography (PSG) with the aims to evaluate 1) the prevalence of RLS in OSA and comparing it with RLS in non-OSA, 2) the prevalence of insomnia, psychiatric, metabolic and cognitive disorders in ComOSAR versus OSA alone, 3) chronic obstructive airway disease (COAD) in ComOSAR versus OSA alone. OSA, RLS and insomnia were diagnosed as per respective guidelines. They were evaluated for psychiatric disorders, metabolic disorders, cognitive disorders and COAD.
Of 326 patients enrolled, 249 were OSA and 77 were non-OSA. 61/249 OSA patients, i.e. 24.4% had comorbid RLS, i.e. ComOSAR. RLS in non-OSA patients was similar (22/77, i.e. 28.5%); P = 0.41. ComOSAR had a significantly higher prevalence of insomnia (26% versus 10.1%; P = 0.016), psychiatric disorders (73.7% versus 48.4%; P = 0.00026) and cognitive deficits (72.1% versus 54.7%, P = 0.016) compared to OSA alone. Metabolic disorders like metabolic syndrome, diabetes mellitus, hypertension and coronary artery disease were also observed in a significantly higher number of patients with ComOSAR versus OSA alone (57% versus 34%; P = 0.0015). COAD was also seen in a significantly higher number of patients with ComOSAR compared to OSA alone (49% versus 19% respectively; P = 0.00001).
It is essential to look for RLS in patients with OSA as it leads to a significantly higher prevalence of insomnia, and cognitive, metabolic and psychiatric disorders. COAD is also more common in ComOSAR compared to OSA alone.
不宁腿综合征（RLS）在阻塞性睡眠呼吸暂停（OSA）患者中很常见，但尚未对其预后重要性进行研究。我们将OSA和RLS并存称为ComOSAR。
对因多导睡眠图（PSG）检查而转诊的患者进行了一项前瞻性观察性研究，目的是评估：1）OSA患者中RLS的患病率，并将其与非OSA患者中的RLS患病率进行比较；2）ComOSAR与单纯OSA相比，失眠、精神、代谢和认知障碍的患病率；3）ComOSAR与单纯OSA相比慢性阻塞性气道疾病（COAD）的患病率。OSA、RLS和失眠均根据各自的指南进行诊断。对他们进行精神障碍、代谢障碍、认知障碍和COAD的评估。
在纳入的326例患者中，249例为OSA患者，77例为非OSA患者。249例OSA患者中有61例（即24.4%）合并RLS，即ComOSAR。非OSA患者中的RLS患病率与之相似（77例中有22例，即28.5%）；P = 0.41。与单纯OSA相比，ComOSAR的失眠患病率显著更高（26%对10.1%；P = 0.016）、精神障碍患病率显著更高（73.7%对48.4%；P = 0.00026）以及认知缺陷患病率显著更高（72.1%对54.7%，P = 0.016）。与单纯OSA相比，ComOSAR患者中代谢综合征、糖尿病、高血压和冠状动脉疾病等代谢障碍的患者数量也显著更多（57%对34%；P = 0.0015）。与单纯OSA相比，ComOSAR患者中COAD的患者数量也显著更多（分别为49%对19%；P = 0.00001）。
对OSA患者进行RLS筛查至关重要，因为它会导致失眠以及认知、代谢和精神障碍的患病率显著升高。与单纯OSA相比，COAD在ComOSAR中也更常见。
