Clinical Features and Contributing Factors of Excessive Daytime Sleepiness in Chinese Obstructive Sleep Apnea Patients: The Role of Comorbid Symptoms and Polysomnographic Variables
Background. The occurrence and severity of excessive daytime sleepiness (EDS) vary considerably among obstructive sleep apnea (OSA) patients. This study was designed to investigate the characteristics of EDS and identify its contributing factors in OSA patients. Methods. This was a cross-sectional s...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2019/5476372 |
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| author | Chuan Shao Huan Qi Ruyi Lang Biyun Yu Yaodong Tang Lina Zhang Xun Wang Ling Wang |
| author_facet | Chuan Shao Huan Qi Ruyi Lang Biyun Yu Yaodong Tang Lina Zhang Xun Wang Ling Wang |
| author_sort | Chuan Shao |
| collection | DOAJ |
| description | Background. The occurrence and severity of excessive daytime sleepiness (EDS) vary considerably among obstructive sleep apnea (OSA) patients. This study was designed to investigate the characteristics of EDS and identify its contributing factors in OSA patients. Methods. This was a cross-sectional study from a tertiary medical center in China. A total of 874 consecutive patients with newly diagnosed OSA were included. Subjective daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). The subjects were assigned to the non-EDS group (582 patients), mild to moderate EDS group (227 patients), and severe EDS group (65 patients) according to the ESS scores. The clinical features and polysomnographic parameters were acquired and analyzed to identify the differences between groups and the determinants of EDS. Results. The age of patients with severe EDS (49.5 ± 11.3) was slightly greater than that of patients with mild to moderate EDS (44.5 ± 10.2) (p<0.05) and non-EDS patients (45.2 ± 12.0) (p<0.05). Body mass index (BMI) was highest in the severe EDS group (29.1 ± 3.6 kg/m2) (p<0.0001), intermediate in the mild to moderate EDS group (27.9 ± 3.3 kg/m2), and lower in the non-EDS group (26.8 ± 3.3 kg/m2). Logistic regression analysis showed waist circumference, memory loss, work/commute disturbances, and sleep efficiency were independently associated with mild to moderate EDS, and the microarousal index, apnea-hypopnea index (AHI), and saturation impair time below 90% were independent contributing factors of mild to moderate EDS. Meanwhile, age, neck circumference, gasping/choking, memory loss, work/commute disturbances, and sleep latency were independently associated with severe EDS, and the AHI and mean SpO2 were independent contributing factors of severe EDS. Conclusions. OSA patients with various severities of EDS are more obese and have more comorbid symptoms compared to patients without EDS. Sleep fragmentation, respiratory events, and nocturnal hypoxia may be predictors of EDS. Comprehensive consideration of demographic, clinical, and polysomnographic factors is required when evaluating OSA patients. |
| format | Article |
| id | doaj-art-be18c65ad9c142909f4c6fe14921e305 |
| institution | Kabale University |
| issn | 1198-2241 1916-7245 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
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| series | Canadian Respiratory Journal |
| spelling | doaj-art-be18c65ad9c142909f4c6fe14921e3052025-02-03T06:46:04ZengWileyCanadian Respiratory Journal1198-22411916-72452019-01-01201910.1155/2019/54763725476372Clinical Features and Contributing Factors of Excessive Daytime Sleepiness in Chinese Obstructive Sleep Apnea Patients: The Role of Comorbid Symptoms and Polysomnographic VariablesChuan Shao0Huan Qi1Ruyi Lang2Biyun Yu3Yaodong Tang4Lina Zhang5Xun Wang6Ling Wang7Department of Special Procurement Ward, The First Affiliated Hospital of Soochow University, Suzhou 215006, ChinaDepartment of Special Procurement Ward, The First Affiliated Hospital of Soochow University, Suzhou 215006, ChinaDepartment of Respiratory Medicine, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo 315040, ChinaDepartment of Respiratory Medicine, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo 315040, ChinaDepartment of Respiratory Medicine, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo 315040, ChinaDepartment of Preventive Medicine, School of Medicine, Ningbo University, Ningbo 315211, ChinaDepartment of Respiratory and Critical Care Medicine, Wuxi No. 2 People’s Hospital, Nanjing Medical University, Wuxi 214002, ChinaDepartment of Special Procurement Ward, The First Affiliated Hospital of Soochow University, Suzhou 215006, ChinaBackground. The occurrence and severity of excessive daytime sleepiness (EDS) vary considerably among obstructive sleep apnea (OSA) patients. This study was designed to investigate the characteristics of EDS and identify its contributing factors in OSA patients. Methods. This was a cross-sectional study from a tertiary medical center in China. A total of 874 consecutive patients with newly diagnosed OSA were included. Subjective daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). The subjects were assigned to the non-EDS group (582 patients), mild to moderate EDS group (227 patients), and severe EDS group (65 patients) according to the ESS scores. The clinical features and polysomnographic parameters were acquired and analyzed to identify the differences between groups and the determinants of EDS. Results. The age of patients with severe EDS (49.5 ± 11.3) was slightly greater than that of patients with mild to moderate EDS (44.5 ± 10.2) (p<0.05) and non-EDS patients (45.2 ± 12.0) (p<0.05). Body mass index (BMI) was highest in the severe EDS group (29.1 ± 3.6 kg/m2) (p<0.0001), intermediate in the mild to moderate EDS group (27.9 ± 3.3 kg/m2), and lower in the non-EDS group (26.8 ± 3.3 kg/m2). Logistic regression analysis showed waist circumference, memory loss, work/commute disturbances, and sleep efficiency were independently associated with mild to moderate EDS, and the microarousal index, apnea-hypopnea index (AHI), and saturation impair time below 90% were independent contributing factors of mild to moderate EDS. Meanwhile, age, neck circumference, gasping/choking, memory loss, work/commute disturbances, and sleep latency were independently associated with severe EDS, and the AHI and mean SpO2 were independent contributing factors of severe EDS. Conclusions. OSA patients with various severities of EDS are more obese and have more comorbid symptoms compared to patients without EDS. Sleep fragmentation, respiratory events, and nocturnal hypoxia may be predictors of EDS. Comprehensive consideration of demographic, clinical, and polysomnographic factors is required when evaluating OSA patients.http://dx.doi.org/10.1155/2019/5476372 |
| spellingShingle | Chuan Shao Huan Qi Ruyi Lang Biyun Yu Yaodong Tang Lina Zhang Xun Wang Ling Wang Clinical Features and Contributing Factors of Excessive Daytime Sleepiness in Chinese Obstructive Sleep Apnea Patients: The Role of Comorbid Symptoms and Polysomnographic Variables Canadian Respiratory Journal |
| title | Clinical Features and Contributing Factors of Excessive Daytime Sleepiness in Chinese Obstructive Sleep Apnea Patients: The Role of Comorbid Symptoms and Polysomnographic Variables |
| title_full | Clinical Features and Contributing Factors of Excessive Daytime Sleepiness in Chinese Obstructive Sleep Apnea Patients: The Role of Comorbid Symptoms and Polysomnographic Variables |
| title_fullStr | Clinical Features and Contributing Factors of Excessive Daytime Sleepiness in Chinese Obstructive Sleep Apnea Patients: The Role of Comorbid Symptoms and Polysomnographic Variables |
| title_full_unstemmed | Clinical Features and Contributing Factors of Excessive Daytime Sleepiness in Chinese Obstructive Sleep Apnea Patients: The Role of Comorbid Symptoms and Polysomnographic Variables |
| title_short | Clinical Features and Contributing Factors of Excessive Daytime Sleepiness in Chinese Obstructive Sleep Apnea Patients: The Role of Comorbid Symptoms and Polysomnographic Variables |
| title_sort | clinical features and contributing factors of excessive daytime sleepiness in chinese obstructive sleep apnea patients the role of comorbid symptoms and polysomnographic variables |
| url | http://dx.doi.org/10.1155/2019/5476372 |
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