Factors affecting fatigue severity in patients with obstructive sleep apnea

Kim, Soo A; Koo, Brian B.; Kim, Do Eui; Hwangbo, Young; Yang, Kwang Ik

doi:10.1111/crj.12682

Cited by 13 publications

(6 citation statements)

References 31 publications

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“…Given that OSA patients have marked sleep impairment, it stands to reason those with CRS may also have a significant reduction in sleep quality, a finding supported by the data in this review. Another study, using the PSQI in those with OSA, demonstrated mean PSQI scores of 8.6, 7.9, and 8.0 for mild, moderate, and severe OSA, respectively 60 . Comparing that study to the data in this review seems to suggest that patients with CRS and NSD appear to have poorer subjective sleep than OSA patients based on the PSQI alone.…”

Section: Discussionmentioning

confidence: 53%

Rhinologic disease and its impact on sleep: a systematic review

Fried

Yuen

et al. 2020

Int Forum Allergy Rhinol

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Background Rhinologic disease can be responsible for systemic symptoms affecting mood, cognition, and sleep. It is unclear whether sleep disturbance in specific rhinologic disorders (chronic rhinosinusitis [CRS], rhinitis, and nasal septal deviation [NSD]) is an obstructive phenomenon or due to other mechanisms. In this review we examine the impact of CRS, rhinitis, and NSD on objective and subjective sleep outcome metrics and draw comparisons to normal controls and patients with known obstructive sleep apnea (OSA). Methods A systematic review of 4 databases (PubMed, Scopus, Cochrane Library, and Web of Science) was performed. Studies reporting on objective (apnea‐hypopnea index [AHI], respiratory disturbance index [RDI], oxygen nadir) and subjective (Epworth Sleepiness Scale [EpSS], Pittsburgh Sleep Quality Index [PSQI], Fatigue Severity Scale [FSS]) sleep parameters and disease‐specific patient‐reported outcome measures (PROMs; 22‐item Sino‐Nasal Outcome Test [SNOT‐22], Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ], Nasal Obstruction Symptom Evaluation [NOSE]) were included. Results The database search yielded 1414 unique articles, of which 103 were included for analysis. Baseline PROMs were at the high end of normal to abnormal for all 3 conditions: EpSS: CRS (9.8 ± 4.0), rhinitis (9.7 ± 4.3), and NSD (8.9 ± 4.6); and PSQI: CRS (11.0 ± 4.5), rhinitis (6.1 ± 3.7), and NSD (8.6 ± 3.5). Objective measures demonstrated a mild to moderate OSA in the studied diseases: AHI: CRS (10.4 ± 11.5), rhinitis (8.6 ± 8.8), and NSD (13.0 ± 6.9). There were significant differences when compared with reported norms in all measured outcomes (p < 0.001). Conclusion Sleep quality is impacted by rhinologic (CRS, rhinitis, NSD) disease. There is likely a mild obstructive component contributing to poor sleep, but other contributing factors may be involved.

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Section: Discussionmentioning

confidence: 53%

Rhinologic disease and its impact on sleep: a systematic review

Fried

Yuen

et al. 2020

Int Forum Allergy Rhinol

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“…Fatigue has been found to be associated with obesity, insomnia, and depression, but not with older age in the general population ( Kim et al, 2017 ; Galland-Decker et al, 2019 ). Increased fatigue is seen in several patient groups, such as cancer patients ( Stone et al, 2000 ; Berger et al, 2015 ), multiple sclerosis ( Rooney et al, 2019 ), and Parkinson’s disease ( Stocchi et al, 2014 ).…”

Section: Discussionmentioning

confidence: 99%

“…Increased fatigue is seen in several patient groups, such as cancer patients ( Stone et al, 2000 ; Berger et al, 2015 ), multiple sclerosis ( Rooney et al, 2019 ), and Parkinson’s disease ( Stocchi et al, 2014 ). Previous studies have suggested an association between fatigue and OSA ( Hossain et al, 2005 ), but studies have also suggested that fatigue is not related to OSA severity ( Kim et al, 2017 ). Studies have shown that the level of fatigue in OSA is driven by depressive symptoms rather than by OSA severity level, though OSA severity influenced fatigue severity ( Bardwell et al, 2003 , 2007 ).…”

Section: Discussionmentioning

confidence: 99%

Association of Excessive Sleepiness, Pathological Fatigue, Depression, and Anxiety With Different Severity Levels of Obstructive Sleep Apnea

et al. 2022

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ObjectiveThe aim of this study was to investigate possible associations between obstructive sleep apnea and fatigue. This naturally led to considering the association between OSA and excessive sleepiness, depression, and anxiety.BackgroundOSA is a highly prevalent sleep disorder, associated with a risk of hypertension, cardiovascular events, daytime sleepiness, poor cognitive function, and sudden death during sleep. Both excessive sleepiness, fatigue, and symptoms of depression are frequently reported.Method5,464 patients referred to a university hospital for obstructive sleep apnea underwent standard respiratory polygraphy. The severity of OSA was defined as either mild, moderate, or severe, using the apnea–hypopnea index. Validated questionnaires were used to assess excessive sleepiness, pathological fatigue, depression, and anxiety.ResultsNearly 70% of the patients were men, and median age was 50 (range: 16–89) years. One in three had moderate-to-severe OSA (AHI ≥ 15). Excessive sleepiness and pathological fatigue were present in 43 and 39%, respectively. The prevalence of possible depression and anxiety was 19 and 28%, respectively. The proportion of patients with male sex, obesity, and excessive sleepiness increased with the severity of OSA. In contrast, the proportion of patients with pathological fatigue did not increase with OSA severity, and there was a decrease in depression and anxiety with increasing OSA severity.ConclusionOur study reports that pathological fatigue, as well as anxiety and depression, did not increase with OSA severity, whereas excessive sleepiness did. Knowledge concerning conditions related to OSA severity may be indicative of pretest probability of OSA and thus change the priority for polygraphy. Furthermore, the high prevalence rates of fatigue, anxiety, and depression among these patients warrant further investigations.

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“…A score of 36 and higher of a maximum of 63 indicates presence of significant or pathologic fatigue. 16 For each patient, relevant demographic, BMI, and medication use including use of anxiolytic and antidepressant medications were collected. The following data were collected from polysomnography (PSG) within the last 3 years: AHI, oxygen desaturation index, respiratory disturbance index, and lowest oxygen saturation.…”

Section: Data Collection Methodsmentioning

confidence: 99%