| Abstract | Kvalitetno spavanje je osnova zdravlja. Opstruktivna apneja u spavanju (dalje u tekstu: OSA) bolest je koja se ogleda poremećajem disanja u spavanju, a obilježavaju je epizode prestanka disanja, epizode buđenja te prekomjeran dnevni umor i pospanost. Terapija CPAP (engl. Continuous Positive Airway Pressure) uređajem jedna je od djelotvornih metoda liječenja OSA-e.
Cilj istraživanja je ustanoviti utjecaj CPAP uređaja na kvalitetu spavanja i dnevnu pospanost u ispitanika s potvrđenom opstrukcijskom apnejom (OSA) umjerenog stupnja.
Ispitanici i metode: Prospektivna studija provodila se dvokratnim ispitivanjem u Laboratoriju za poremećaje spavanja, Klinike za neurologiju Kliničkog bolničkog centra Zagreb, u razdoblju od 2019. do 2021. godine. U uzorak je uključeno trideset ispitanika, a osnovni uključni kriterij je AHI 15-29/sat što označava umjerenu OSA-u. Pittsburgh indeks kvalitete spavanja i Epworth skala pospanosti - osnovne metode ove studije - ispunjavaju se dvokratno: po dijagnosticiranju OSA-e te nakon šest mjeseci svakodnevne primjene CPAP uređaja prilikom kontrolnog pregleda. AHI indeks, kao uključni kriterij, odnosno stupanj OSA-e klasificiran je pri postavljanju dijagnoze OSA-e (poligraf, polisomnografija) i nakon 6 mjeseci primjene CPAP uređaja očitanog s memorijske kartice uređaja. Za statističku analizu korišten je statistički program MedCalc Statistical Software version 19.1.7 (MedCalc Software Ltd, Ostend, Belgium; https://www.medcalc.org; 2020) i SPSS (IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.). Ispitivano je postoji li statistički značajna razlika u kvaliteti spavanja, njezinim potkomponentama (subjektivna kvaliteta spavanja, latencija uspavljivanja, trajanje spavanja, uobičajena učinkovitost spavanja, poremećaj spavanja, korištenje lijekova za spavanje, dnevna disfunkcija i dnevna pospanost prije te nakon šest mjeseci primjene CPAP uređaja.
Rezultati: Od uključenih trideset ispitanika, 37 posto muškaraca i 63 posto žena, medijan dobi 56 godina i medijan indeksa tjelesne mase 32 kg/m2 ustanovili smo značajno poboljšanje kvalitete spavanja (procijenjena Pittsburgovom skalom). (razlika medijana -8,5; 95% raspon pouzdanosti -9,5 do -7,5, P < 0,001), i skala pospanosti (Epworth skala) (medijan razlike -5,5; 95% interval pouzdanosti -8,5 do -3, P = 0,003)
Zaključak: Ustanovljena je povezanost između kvalitete spavanja procijenjene Pittsburg upitnikom i trajanje primjene CPAP uređaja, te povezanost dnevne pospanosti procijenjene Epworth skalom. |
| Abstract (english) | Sleep quality is the foundation of a healthy life. Obstructive sleep apnea (OSA) is a disease that manifests itself in sleep-disordered breathing, and is characterized by episodes of cessation of breathing, episodes of waking up, and excessive daily fatigue and drowsiness. One of the effective methods of treating OSA (Obstructive Sleep Apnea) is by CPAP (Continuous Positive Airway Pressure) device.
The aim of this study was to determine the effects of CPAP devices on sleep quality and daytime sleepiness in subjects with confirmed moderate obstructive sleep apnea (OSA).
Subjects and methods: The prospective study was conducted by double examination in the Laboratory for Sleep Disorders, Clinic of Neurology, Clinical Hospital Center Zagreb, in the period from 2019 to 2021. Thirty subjects were included in the sample, and the basic inclusion criterion is AHI 15-29/ per hour which indicates moderate OSA. The Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale - the basic methods of this study – were done twice: upon diagnosis of OSA and after six months of daily use of the CPAP device during the follow-up examination. The AHI index, as an inclusion criterion, i.e. the degree of OSA, is classified when diagnosing OSA (polygraph, polysomnography) and after 6 months of using a CPAP device. MedCalc Statistical Software version 19.1.7 (MedCalc Software Ltd, Ostend, Belgium; https://www.medcalc.org; 2020) and SPSS (IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) were used for statistical analysis. We analysed whether there was a statistically significant difference in sleep quality, its subcomponents (subjective sleep quality, sleep latency, sleep duration, normal sleep efficiency, sleep disturbance, use of sleep medications, daily dysfunction and daytime sleepiness before and after six months of CPAP use).
Results: Of the thirty subjects included, 37 percent of men and 63 percent of women, median age 56 years, and median body mass index 32 kg / m2, we found a significant improvement in sleep quality (estimated according to the Pittsburgh scale). (mean difference -8.5; 95% confidence range -9.5 to -7.5, P <0.001), and drowsiness scale (Epworth scale) (mean difference -5.5; 95% confidence interval -8.5 to -3, P = 0.003)
Conclusion: A correlation was found between the sleep quality assessed by the Pittsburg questionnaire and the duration of CPAP device application, and the correlation between daily sleepiness assessed by the Epworth scale. |
