Daytime sleepiness and its determining factors in Chinese obstructive sleep apnea patients

Chen, Rui; Xiong, Kang-Ping; Lian, Yixin; Huang, Juan-ying; Zhao, Minyan; Li, Jianxiang; Liu, Chunfeng

doi:10.1007/s11325-010-0337-4

Cited by 70 publications

(68 citation statements)

References 28 publications

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“…The stepwise multiple regression analysis performed to evaluate the correlations of individual clinical and polysomnographic variables with the ESS score revealed that the ESS score significantly correlated with the oxygen desaturation index (ODI), apnoea -hypopnea index (AHI), and body mass index (BMI), and ODI was the strongest determinant of ESS score. 32 In similar study, when a stepwise multiple regression analysis was performed, neck circumference in men and BMI in women were shown to be the strongest predictors of sleep apnoea which is also seen in our study. 33 In a two-phase cross-sectional study, the prevalence and related clinical features of obstructive sleep apnoeahypopnea (OSAH) in the general population were estimated.…”

supporting

confidence: 87%

Role of polysomnography in patients of snoring

Sachdeva

Sharma

Kajal

2017

Int J Otorhinolaryngol Head Neck Surg

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Background: A useful working definition of snoring is the production of sound by the upper aero digestive tract during sleep. Polysomnography (PSG) is the monitoring of physiological parameters and physiological or pathological events in sleep. Methods: Fifty patients of either sex, having age >16 years were randomly selected from the ENT OPD based on the pre-determined inclusion and exclusion criteria. Subjective evaluation of snoring was done using Epworth sleepiness Scale. Neck circumference and body mass index were calculated in all patients. Then, complete local ENT examination was done including diagnostic nasal endoscopy. After that, full night polysomnography test of at least 6 hours duration was conducted. Results: Normal nasal endoscopy was seen in 64% of patients. DNS, DNS with ITH/MTH, ITH/MTH unilateral, ITH/MTH bilateral and nasal polyps were seen in 14%, 12%, 0%, 8% and 4% of patients respectively. Mean apnoea-hypopnoea index (AHI) was 6.58. 48% of the patients in our study had normal AHI (0-4). Mild, moderate and severe AHI was present in 44%, 6% and 2% of the patients respectively. Conclusions: All cases of snoring must be subjected to thorough clinical examination and nasal endoscopy and thereafter, be evaluated further for presence of sleep apnoea with polysomnography.

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supporting

confidence: 87%

Role of polysomnography in patients of snoring

Sachdeva

Sharma

Kajal

2017

Int J Otorhinolaryngol Head Neck Surg

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“…53 This is in line with the reported discordance between subjective and objective sleepiness measures, 54,55 and our findings. In fact, more recent studies of OSA populations have suggested that desaturating events appear to correlate with subjective, 56 but not objective, sleepiness. 55 The correlation between sleep fragmentation measures and daytime sleepiness frequently accounts for only a small part of the total variance, 47 which is why we initially sought to explore nondesaturating breathing disturbances, regardless of association, as a means of determining whether the sleep-breathing events, in and of themselves, justify their inclusion into the AHI.…”

mentioning

confidence: 99%

Breathing Disturbances Without Hypoxia Are Associated With Objective Sleepiness in Sleep Apnea

Koch

Schneider

Finn

et al. 2017

Sleep

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Study Objectives: To determine whether defining two subtypes of sleep-disordered breathing (SDB) events-with or without hypoxia-results in measures that are more strongly associated with hypertension and sleepiness. Methods: A total of 1 022 participants with 2 112 nocturnal polysomnograms from the Wisconsin Sleep Cohort were analyzed with our automated algorithm, developed to detect breathing disturbances and desaturations. Breathing events were time-locked to desaturations, resulting in two indices-desaturating (hypoxia-breathing disturbance index [H-BDI]) and nondesaturating (nonhypoxia-breathing disturbance index [NH-BDI]) events-regardless of arousals. Measures of subjective (Epworth Sleepiness Scale) and objective (2 981 multiple sleep latency tests from a subset of 865 participants) sleepiness were analyzed, in addition to clinically relevant clinicodemographic variables. Hypertension was defined as BP ≥ 140/90 or antihypertensive use. Results: H-BDI, but not NH-BDI, correlated strongly with SDB severity indices that included hypoxia (r ≥ 0.89, p ≤ .001 with 3% oxygen-desaturation index [ODI] and apnea hypopnea index with 4% desaturations). A doubling of desaturation-associated events was associated with hypertension prevalence, which was significant for ODI but not H-BDI (3% ODI OR = 1.06, 95% CI = 1.00-1.12, p < .05; H-BDI OR 1.04, 95% CI = 0.98-1.10) and daytime sleepiness (β = 0.20 Epworth Sleepiness Scale [ESS] score, p < .0001; β = −0.20 minutes in MSL on multiple sleep latency test [MSLT], p < .01). Independently, nondesaturating event doubling was associated with more objective sleepiness (β = −0.52 minutes in MSL on MSLT, p < .001), but had less association with subjective sleepiness (β = 0.12 ESS score, p = .10). In longitudinal analyses, baseline nondesaturating events were associated with worsening of H-BDI over a 4-year follow-up, suggesting evolution in severity. Conclusions: In SDB, nondesaturating events are independently associated with objective daytime sleepiness, beyond the effect of desaturating events.

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“…In ag re ement with the li te ra tu re, we de tec ted that AHI and res pi ra tory-re la ted aro u sals we re mo re im por tant in exp la i ning pre sen ce of EDS. 9,10,16,17 Si mi lar to ot her stu di es, we sho wed that the OSA pa ti ents with EDS we re yo un ger and the re was a ne ga ti ve re la ti ons hip bet we en ESS sco re and age. 16,18 One study in di ca ted a dec re a se in nigh ttime sle ep ef fi ci ency and day ti me sle ep den sity in older com pa red to yo un ger pa ti ents as a re sult of the shift of the he mos ta tic sle ep mec ha nism to wards wa ke ful ness.…”

Section: Discussionmentioning

confidence: 79%

Comparison of Polysomnography Variables in Obstructive Sleep Apnea Patients with or without Excessive Daytime Sleepiness

Gülbay¹,

Acican²,

Ciftci³

et al. 2014

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T OOb b j je ec c t ti i v ve e: : Excessive daytime sleepiness (EDS) is a common symptom in patients with obstructive sleep apnea (OSA), and the reason for this could not be fully elucidated. The aim of this study was to compare polysomnographic and demographic features of patients with OSA with or without EDS according to Epworth Sleepiness Scale (ESS). M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A total of 82 adult patients who were diagnosed with OSA with polysomnography were retrospectively divided into 2 groups in terms of having EDS (ESS>10) or not (ESS≤10) according to ESS score. R Re es su ul lt ts s: : Forty six patients had an ESS score >10. Patients with OSA suffering from sleepiness were younger (p=0.010), more obese (p=0.039), had higher arousal index (p=0.051) and apnea hypopnea index (AHI) (p=0.036) on polysomnography. There was no gender difference between two groups (p=0.423). Polysomnographic findings revealed that there were no differences in total sleep time, sleep efficiency or overall distribution of sleep stages (N1,N2, N3, REM), or nocturnal mean and minimum saturation (p=0. 516, p=0.790, p=0.674, p=0.852, p=0.677, p=0.137, p=0.286, p=0.353, respectively). On multivariate regression analysis, arousal index, total AHI, and age were effective in determination of ESS score (p<0.001). C Co on nc cl lu us si io on n: : OSA patients with EDS were younger and more obese when compared to OSA patients with no EDS. No single factor was effective for detection of EDS with ESS score. Rather, factors such as severity of OSA, arousal index, and age were collectively decisive.K Ke ey y W Wo or rd ds s: : Sle ep ap ne a, obs truc ti ve; poly som nog raphy Ö ÖZ ZE ET T A Am ma aç ç: : Gün düz uy ku lu luk, obs trük tif uy ku ap ne li (OSA) has ta lar da sık gö rü len, an cak ne deni tam ola rak ay dın la tı la ma mış bir semp tom dur. Ça lış ma da Ep worth uy ku luk luk ska la sı (ESS) so nucu na gö re aşı rı uy ku lu lu ğu olan ve ol ma yan OSA' lı has ta la rın po li som nog ra fik ve de mog ra fik özel lik le ri nin kar şı laş tı rıl ma sı amaç lan dı. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Po li som nog ra fi ile OSA ta nı sı konmuş 82 [Ap ne hi pop ne in dek si (AHİ)>15/sa] eriş kin has ta (28 ka dın/54 er kek), ESS so nu cu na gö re gün düz aşı rı uy ku lu lu ğu (GA U) olan (ESS>10) ve ol ma yan (ESS≤10) şek lin de 2 grup ta ret ros pek tif ola rak in ce len di. B Bu ul l g gu u l la ar r: : Has ta lar dan 46'sın da ESS>10 idi. Gün düz uy ku lu lu ğu olan OSA' lı has talar da ha genç (p=0,010) ve obez di (0,039). Bu gru bun po li som nog ra fi le rin de aro u sal in dek si (p=0,051) ve ap ne hi pop ne in dek si (AHİ) da ha yük sek ti (p=0,036). İki grup ara sın da cin si yet fark lı lı ğı gö rül -me di (p=0,423). Po li som nog ra fi le rin de to tal uy ku sü re si, uy ku et kin li ği ya da uy ku ev re le ri nin da -ğı lı mı (N1,N2,N3,REM), nok tur nal or ta la ma sa tu ras yon ve en dü şük sa tu ras yon de ğer le ri açı sın dan, iki grup ara...

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Daytime sleepiness and its determining factors in Chinese obstructive sleep apnea patients

Abstract: EDS is correlated with the severity of OSAHS. More severe patients are characterized by higher ESS score, higher BMI, and progressive worsening of nocturnal hypoxemia. Nocturnal hypoxemia is a major determinant of EDS in Chinese OSAHS patients.

Cited by 70 publications

References 28 publications

Role of polysomnography in patients of snoring

Role of polysomnography in patients of snoring

Breathing Disturbances Without Hypoxia Are Associated With Objective Sleepiness in Sleep Apnea

Comparison of Polysomnography Variables in Obstructive Sleep Apnea Patients with or without Excessive Daytime Sleepiness

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