The Clinical Predictors of Sleepiness Correlated with the Multiple Sleep Latency Test in an Asian Singapore Population

Leng, Poh Hock; Low, Su Ying; Hsu, Anne Ann Ling; Chong, Stephanie Fook

doi:10.1093/sleep/26.7.878

Cited by 19 publications

(18 citation statements)

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“…We found that patients with higher AHI, more severe oxygen desaturation or more fragmented sleep tended to have higher ratings of daytime sleepiness. The findings were consistent with previous studies [19, 20]. …”

Section: Discussionsupporting

confidence: 94%

Insomnia Subtypes and Their Relationships to Daytime Sleepiness in Patients with Obstructive Sleep Apnea

Chung

2005

Respiration

118

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Background: Insomnia and obstructive sleep apnea syndrome (OSA) are the two most common sleep disorders. Studies showed that insomnia complaints were prevalent in OSA. Relatively little is known about the causes of insomnia in OSA and whether etiological factors differ for insomnia subtypes. We hypothesized that sleep onset problem was mainly due to hyperarousal and sleep maintenance difficulty was primarily related to sleep-disordered breathing. Objectives: To determine the prevalence of insomnia subtypes in OSA, compare subjects with sleep onset insomnia, sleep maintenance insomnia and no insomnia symptom, and study the relationship of insomnia subtypes to daytime sleepiness. Methods: We analyzed intake questionnaires and polysomnography and Multiple Sleep Latency Test results of 157 OSA patients. Results: Forty-two percent of the sample had at least one problematic insomnia symptom. The prevalence of sleep onset insomnia, sleep maintenance insomnia and insomnia with early awakening was 6, 26 and 19%, respectively. Patients with sleep onset insomnia had significantly lower apnea-hypopnea (AHI) and arousal indices. There were significant inverse relationships between sleep onset insomnia and measures of daytime sleepiness. On the contrary, subjects with repeated wakening had more severe subjective sleepiness. Results were similar in patients with AHI ≧5 or ≧15. Conclusions: Insomnia symptoms were common in OSA patients. Insomnia subtypes related differently to measures of daytime sleepiness. Our findings suggest that OSA patients with sleep onset insomnia may be in a state of hyperarousal. It is clinically relevant to examine insomnia subtypes, which may influence the treatment decision in sleep-disordered breathing.

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Section: Discussionsupporting

confidence: 94%

Insomnia Subtypes and Their Relationships to Daytime Sleepiness in Patients with Obstructive Sleep Apnea

Chung

2005

Respiration

118

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“…The distribution of ESS scores was also skewed and the threshold matched with the 25th percentile score. In the previous study, an ESS of ≥8 reliably predicted sleep latency of less than 10 min on the multiple sleep latency test [34]. Sleep duration was categorized into five groups (<6, 6-7, 7-8, 8-9, and ≥9 h).…”

Section: Discussionmentioning

confidence: 96%

“…The finding suggests that daytime sleepiness might impair sustained attention even at the degree of sleepiness below the level of "excessive" sleepiness. An ESS of ≥8 reliably predicted a moderate degree of daytime sleepiness on the multiple sleep latency test [34]. One caveat to interpret the correlation between daytime sleepiness and PVT performance is that daytime sleepiness measured by ESS is determined by multiple factors [42,43].…”

Section: Discussionmentioning

confidence: 99%

Daytime sleepiness associated with poor sustained attention in middle and late adulthood

et al. 2015

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“…The ESS has been found to be a valid and reliable tool to separate normal adult subjects from patients with sleep disorders (Johns, 1991,Pallesen, et al, 2007). Studies have shown that ESS scores correlate at least moderately with objective measures of sleepiness (Cai, et al, 2013,Johns, 1991,Leng, et al, 2003). Scores range from 0–24.…”

Section: Methodsmentioning

confidence: 99%

Excessive daytime sleepiness and fatigue may indicate accelerated brain aging in cognitively normal late middle-aged and older adults

et al. 2017

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Excessive daytime sleepiness (EDS) and fatigue increases with age. The aim of this study was to investigate the association between EDS and fatigue with cortical thickness and hippocampal volume in cognitively normal, late middle-aged and older adults. We performed a cross-sectional observational study of 1374 cognitively-normal subjects aged 50 years and older who had a structural MRI. Regional cortical thickness and hippocampal volume were measured. Multiple linear regression models were fit to explore associations between EDS and fatigue and structural MRI measures in different brain regions, adjusting for multiple covariates. EDS was defined as Epworth Sleepiness Scale ≥10. Fatigue severity was assessed with the Beck Depression Inventory-2. 208 participants had EDS, 27 had significant fatigue, and 11 had both. Participants with EDS or fatigue had significantly lower cognitive scores, more disturbed sleep, and medical comorbidities. The presence of EDS was associated with both global and regional atrophy, whereas fatigue was more associated with frontal and temporal changes. Cortical thinning predicted by EDS and fatigue was maximal in the temporal region with average reduction of 34.2 µm (95% CI, −54.1, −14.3; P=.001) and 90.2 µm (95% CI, −142.1, −38.2; P=.001), respectively. Fatigue was also associated with hippocampal volume reduction of −374.2 mm3 (95%CI, −670.8, −77.7; P=.013). Temporal cortical thinning predicted by presence of EDS and fatigue was equivalent to more than 3.5 and nine additional years of aging, respectively. EDS and fatigue were associated with cortical thickness reduction primarily in regions with increased age-susceptibility, which may indicate accelerated brain aging.

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The Clinical Predictors of Sleepiness Correlated with the Multiple Sleep Latency Test in an Asian Singapore Population

Abstract: The Epworth Sleepiness Scale and apnea-hypopnea index are useful predictors of sleepiness in our Asian Singapore population.

Cited by 19 publications

References 0 publications

Insomnia Subtypes and Their Relationships to Daytime Sleepiness in Patients with Obstructive Sleep Apnea

Insomnia Subtypes and Their Relationships to Daytime Sleepiness in Patients with Obstructive Sleep Apnea

Daytime sleepiness associated with poor sustained attention in middle and late adulthood

Excessive daytime sleepiness and fatigue may indicate accelerated brain aging in cognitively normal late middle-aged and older adults

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