| Abstract | Cilj: Istražiti pojavnost simptoma prekomjerne dnevne pospanosti, kao jednog od vodećih simptoma opstrukcijske apneje tijekom spavanja, s obzirom na dob, spol, antropometrijske značajke pacijenata te stupanj opstrukcijske apneje tijekom spavanja.
Ispitanici i postupci: U istraživanje je uključeno 2215 pacijenata (709 žena i 1503 muškarca), svi stariji od 18 godina, Centra za medicinu spavanja Medicinskog fakulteta u Splitu i KBC-a Split. Svi pacijenti su zbog sumnje na opstrukcijsku apneju tijekom spavanja, upućeni na poligrafiju/polisomnografiju u Centar za medicinu spavanja u vremenskom razdoblju od 15.3.2011. do 20.5.2022. godine. Prikupljeni su demografski, antropometrijski i anamnestički podaci, dok je razina dnevne pospanosti procijenjena s pomoću Epworthove ljestvice pospanosti.
Rezultati:. Muškarci su u odnosu na žene bili statistički značajno viši (181,618,94 vs. 167,566,62, P<0,001), mlađi (53,0813,34 vs. 55,4212,42, P=0,007), imali su veći opseg vrata (43,333,96 vs. 37,394,14, P<0,001), veći opseg struka (109,5014,92 vs. 99,2916,53, P<0,001), kao i veći indeks tjelesne mase (30,335,48 vs. 29,046,45, P<0,001). Žene su u odnosu na muškarce imale značajno veću razinu prekomjerne dnevne pospanosti (7,694,86 vs. 7,454,55, P=0,038). Od ukupno 2215 ispitanika, 39,8% imalo je OSA teškog stupnja, od čega je 41,3% ispitanika imalo prekomjernu dnevnu pospanost, 16,6% ispitanika s OSA teškog stupnja imalo je blagu pospanost, dok 42,1% ispitanika s OSA teškog stupnja nije imalo dnevnu pospanost. Nadalje među ispitanicima kojima nije dijagnosticirana OSA pronađeno je da 37,8% ispitanika ima prekomjernu dnevnu pospanost. Udio REM stadija spavanja iznosio je 13,81% u ispitanika koji nisu imali prekomjernu dnevnu pospanost, 15,22% u ispitanika koji su imali blagu pospanost te 15,25% u ispitanika s prekomjernom dnevnom pospanošću (P=0,029). Učinkovitost spavanja bila je smanjena u svim skupinama ispitanika s obzirom na razinu dnevne pospanosti odnosno je iznosila 74,69% u ispitanika koji nisu imali prekomjernu dnevnu pospanosti, 76,59% u ispitanika koji su imali blagu pospanost te 79,40% u ispitanika s prekomjernom dnevnom pospanošću (P<0,001). Razinu dnevne pospanosti najbolje se može predvidjeti s razinom učinkovitosti spavanja (P<0,001), potom povećanom vrijednosti AHI (P=0,003) te mlađom dobi ispitanika (P=0,008).
Zaključak: U odnosu na stupanj OSA rezultati našeg istraživanja ukazuju na značajno veću prisutnost prekomjerne dnevne pospanosti u ispitanika sa teškom OSA. Prekomjerna dnevna pospanost značajno je veća u žena nego u muškaraca. Razina dnevne pospanosti najbolje se može predvidjeti vrijednošću učinkovitosti spavanja, potom stupnjem OSA, te mlađom životnom dobi, što ukazuje na važnost pravovremenog prepoznavanja simptoma prekomjerne pospanosti i reagiranja u smislu poduzimanja dijagnostičkih i terapijskih postupaka kojima će se spriječiti negativne posljedice prekomjerne dnevne pospanosti u bolesnika s poremećajima disanja tijekom spavanja. |
| Abstract (english) | Objective: To establish the occurrence of symptoms of excessive daytime sleepiness as one of the leading symptoms of obstructive sleep apnea, concerning the age, sex, anthropometric features of the patients, and the degree of obstructive sleep apnea.
Respondents and Methods: 2,215 patients (709 women and 1,503 men) of the Center for Sleep Medicine of the University of Split School of Medicine and the Split Clinical Hospital Center were included in the study. All participants were referred to the Center for Sleep Medicine for polygraphy/polysomnography between 15/03/2011 and 20/5/2022. Demographic, anthropometric and anamnestic data were collected; the ESS was the only questionnaire used to evaluate sleepiness.
Results: Compared to women, men were statistically significantly taller (181.61±8.94 vs. 167.56±6.62, P<0.001), younger (53.08±13.34 vs. 55.42±12.42, P=0.007), had a larger neck circumference (43.33±3.96 vs. 37.39±4.14, P<0.001), a larger waist circumference (109.50±14.92 vs. 99.29±16.53, P<0.001), as well as a higher body mass index (30.33±5.48 vs. 29.04±6.45, P<0.001). Women had a significantly higher level of excessive daytime sleepiness than men (7.69±4.86 vs. 7.45±4.55, P=0.038). Of 2,215 respondents, 39.8% had severe OSA, among whom excessive daytime sleepiness was found in 41.3%, mild sleepiness in 16.6%, and no daytime sleepiness in 42.1%. Furthermore, among respondents who were not diagnosed with OSA, 37.8% were found to have excessive daytime sleepiness. The share of REM sleep was 13.81% of the total in respondents with no daytime sleepiness, 15.22% in respondents with mild sleepiness, and 15.25% in respondents with excessive daytime sleepiness (P=0.029). Sleep efficiency was reduced in all groups concerning daytime sleepiness, i.e. it amounted to 74.69% in subjects who did not have excessive daytime sleepiness, 76.59% in subjects who had mild sleepiness and 79.40% in subjects with excessive daytime sleepiness (P<0.001). Daytime sleepiness can most accurately be predicted concerning, in order, a lower level of sleep efficiency (P<0.001), increased AHI values (P=0.003), and younger age of the subject (P=0.008).
Conclusion: The results of our study indicate a significantly higher presence of excessive daytime sleepiness in respondents with severe OSA. Furthermore, excessive daytime sleepiness is substantially more pronounced in women than men. The level of daytime sleepiness can best be predicted by sleep efficiency values, then by the severity of OSA, and finally, by younger age. Results emphasize the importance of timely recognition of the signs of excessive sleepiness and an appropriate response regarding diagnostic and therapeutic procedures that can prevent the negative consequences of excessive daytime sleepiness in patients with sleep-disordered breathing. |
