Multiple dimensions of excessive daytime sleepiness

Smith, Sasha; Rossdale, Jennifer; Serry, M Yaseen H; Sekaran, Anisha; Drakatos, Panagis; Steier, Joerg

doi:10.21037/jtd.2017.11.32

Cited by 19 publications

(22 citation statements)

References 26 publications

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“…The other significant determinant of depressive mood in our cohort was ESS score, which is also in line with the previous reports. In one study, 50 patients who were referred to the sleep clinic for sleep disturbances and EDS were evaluated based on the Hospital Anxiety and Depression Scale questionnaires and a significant association between EDS and depression was demonstrated (Smith et al., ). In a large cross‐sectional survey of 8,937 adults, sleepiness was associated with an increased risk of major depression (Ohayon, ).…”

Section: Discussionmentioning

confidence: 99%

Determinants of depressive mood in coronary artery disease patients with obstructive sleep apnea and response to continuous positive airway pressure treatment in non‐sleepy and sleepy phenotypes in the RICCADSA cohort

Balcan

Thunström

Strollo

et al. 2019

Journal of Sleep Research

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We explored determinants of depressive mood in adults with coronary artery disease and obstructive sleep apnea and response to positive airway pressure treatment in sleepy and non‐sleepy phenotypes. In this secondary analysis of the RICCADSA trial conducted in Sweden, 493 cardiac patients with obstructive sleep apnea (n = 386) or no obstructive sleep apnea (n = 107) with complete Epworth Sleepiness Scale and Zung Self‐rating Depression Scale questionnaires were included. Sleepy (Epworth Sleepiness Scale ≥10) versus non‐sleepy (Epworth Sleepiness Scale <10) patients with depressive mood (Zung Self‐rating Depression Scale score ≥50) were evaluated after 3 and 12 months of positive airway pressure treatment. In all, 133 patients (27.0%) had depressive mood (29.3% of obstructive sleep apnea versus 18.7% of no obstructive sleep apnea; p = 0.029), with a higher percentage among the sleepy phenotype (36.9% versus 24.5%; p = 0.009). In multivariate analysis, depressive mood was significantly associated with female sex, body mass index and Epworth Sleepiness Scale. Among 97 obstructive sleep apnea patients with depressive mood at baseline, there was a significant reduction in the scores at follow‐up both in the sleepy and non‐sleepy patients allocated to positive airway pressure treatment, whereas no significant changes were observed in the untreated group (p = 0.033). The device use (hr/night) predicted improvement in mood (odds ratio, 1.33; 95% confidence interval, 1.10–1.61; p = 0.003) adjusted for age, female sex, body mass index, left ventricular ejection fraction, apnea–hypopnea index and delta Epworth Sleepiness Scale score. We conclude that obstructive sleep apnea was associated with depressive mood in adults with coronary artery disease. Treatment with positive airway pressure improved mood in both phenotypes, independent of the confounding factors.

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Section: Discussionmentioning

confidence: 99%

Determinants of depressive mood in coronary artery disease patients with obstructive sleep apnea and response to continuous positive airway pressure treatment in non‐sleepy and sleepy phenotypes in the RICCADSA cohort

Balcan

Thunström

Strollo

et al. 2019

Journal of Sleep Research

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“…The meta-analysis of non-sleepy OSA participants, demonstrated a statistically but not clinically significant reduction in ESS. However, given the limitations of the ESS in assessing sleepiness, 164,165 patients with OSA who are non-sleepy or minimally symptomatic as assessed by the ESS, may experience clinically important improvements in sleepiness. As such, the clinician assessment of sleepiness should not be solely based on the ESS.…”

Section: Patient Values and Preferencesmentioning

confidence: 99%

Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment

Patil

Ayappa

Caples

et al. 2019

Journal of Clinical Sleep Medicine

471

306

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Introduction:The purpose of this systematic review is to provide supporting evidence for the clinical practice guideline for the treatment of obstructive sleep apnea (OSA) in adults using positive airway pressure (PAP). Methods: The American Academy of Sleep Medicine commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies that compared the use of PAP with no treatment as well as studies that compared different PAP modalities. Meta-analyses were performed to determine the clinical significance of using PAP in several modalities (ie, continuous PAP, auto-adjusting PAP, and bilevel PAP), to treat OSA in adults. In addition, meta-analyses were performed to determine the clinical significance of using an in-laboratory versus ambulatory strategy for the initiation of PAP, educational and behavioral interventions, telemonitoring, humidification, different mask interfaces, and flexible or modified pressure profile PAP in conjunction with PAP to treat OSA in adults. Finally, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence for making recommendations. Results: The literature search resulted in 336 studies that met inclusion criteria; 184 studies provided data suitable for meta-analyses. The data demonstrated that PAP compared to no treatment results in a clinically significant reduction in disease severity, sleepiness, blood pressure, and motor vehicle accidents, and improvement in sleep-related quality of life in adults with OSA. In addition, the initiation of PAP in the home demonstrated equivalent effects on patient outcomes when compared to an in-laboratory titration approach. The data also demonstrated that the use of auto-adjusting or bilevel PAP did not result in clinically significant differences in patient outcomes compared with standard continuous PAP. Furthermore, data demonstrated a clinically significant improvement in PAP adherence with the use of educational, behavioral, troubleshooting, and telemonitoring interventions. Systematic reviews for specific PAP delivery method were also performed and suggested that nasal interfaces compared to oronasal interfaces have improved adherence and slightly greater reductions in OSA severity, heated humidification compared to no humidification reduces some continuous PAP-related side effects, and pressure profile PAP did not result in clinically significant differences in patient outcomes compared with standard continuous PAP.

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“…37,5% do total de pacientes avaliados apresentaram sonolência excessiva diurna em diferentes graus, de acordo com a avaliação da ESS. É importante destacar que a sonolência excessiva diurna interfere no humor, emoção, fadiga, diminui a atenção, a concentração, a paciência, acarreta déficit cognitivo, redução do rendimento laboral e acidentes de tráfego (7,10,11,15), repercutindo direta ou indiretamente nos serviços de saúde e na previdência, elevando o percentual de usuários de ambos, representando um problema de saúde pública.…”

Section: Discussionunclassified

Avaliação da Qualidade do Sono e da Sonolência Excessiva diurna em pacientes com enfermidades neurológicas/ Assessment of Sleep Quality and Excessive Daytime Sleepiness in Patients with Neurological Disorders

Fernandes¹,

Barbosa²,

Albano³

et al. 2021

Braz. J. Hea. Rev.

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escolhidos aleatoriamente, entre 17 e 59 anos de idade. A pesquisa realizada foi do tipo transversal, qualitativa e quantitativa. A análise dos dados foi realizada por meio de estatística inferencial univariada e bivariada. Resultados: 60,1% dos entrevistados relataram qualidade do sono boa ou muito boa, porém 73,6% apresentaram alteração na qualidade do sono, sendo que destes 50,2% apresentaram qualidade ruim e 23,4% apresentaram distúrbio do sono. 37,5% do total de pacientes apresentam algum grau sonolência excessiva diurna. Discussão e Conclusões: Este estudo alerta o alto índice de comprometimento do sono em pacientes ambulatoriais cuja queixa principal não tinha relação direta com o sono. Foi observada uma má percepção relacionada à qualidade de sono desta população, o que pode levar a um subdiagnóstico. Abordagens a cerca da qualidade do sono, queixa tão subestimada pela população em geral, deve ser rotina nos atendimentos ambulatoriais devido ao prejuízo global na qualidade de vida.

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Multiple dimensions of excessive daytime sleepiness

Cited by 19 publications

References 26 publications

Determinants of depressive mood in coronary artery disease patients with obstructive sleep apnea and response to continuous positive airway pressure treatment in non‐sleepy and sleepy phenotypes in the RICCADSA cohort

Determinants of depressive mood in coronary artery disease patients with obstructive sleep apnea and response to continuous positive airway pressure treatment in non‐sleepy and sleepy phenotypes in the RICCADSA cohort

Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment

Avaliação da Qualidade do Sono e da Sonolência Excessiva diurna em pacientes com enfermidades neurológicas/ Assessment of Sleep Quality and Excessive Daytime Sleepiness in Patients with Neurological Disorders

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