Abstract | Cilj: Usporediti subjektivnu procjenu kvalitete spavanja OSA pacijenata s objektivnim
pokazateljima cjelonoćne polisomnografije.
Ispitanici i metode: U istraživanju je sudjelovalo ukupno 370 ispitanika (226 muškaraca i
144 žene) u dobi od 20 do 82 godine. Svi ispitanici su pacijenti Centra za medicinu spavanja
KBC-a Split i Medicinskog fakulteta u Splitu, registrirani u periodu od 2013. do 2021. godine.
Pacijenti su ispunili PSQI, ESS i STOP upitnike te im je snimljena cjelonoćna
polisomnografija. Iz istraživanja su isključeni poligrafski snimani pacijenti, pacijenti mlađi od
18 godina ili oni bez cjelovitih podataka. Analizirana je subjektivna procjena kvalitete
spavanja mjerena PSQI upitnikom temeljem koje su ispitanici podijeljeni u dvije skupine:
dobri i loši spavači. Subjektivni i objektivni parametri uspoređeni su u muškaraca i žena, te u
skupinama dobrih i loših spavača.
Rezultati: Od ukupno 370 ispitanika, njih 202 (54,59) svrstano je u kategoriju „dobri
spavači“ dok preostalih 168 (45,41) pripada kategoriji „loši spavači“. U skupini dobrih
spavača ima znatno više muškaraca u odnosu na žene (133 prema 69, P=0,039). Također,
žene su ostvarile veći ukupni PSQI rezultat u usporedbi s muškarcima (9,213,89 prema
8,043,43, P=0,003). Nadalje, žene imaju veću latenciju spavanja, češće smetnje spavanja i
češće koriste farmakoterapiju za spavanje. Prosječna AHI vrijednost znatno je veća u
muškaraca nego u žena (24,2 (10,1-47,6) prema 12,55 (4,18-33,25), P0,001). Muškarci su
manji dio noći proveli u stadiju N3 u usporedbi sa ženama (6,75% (1,53-11,9) prema 8,65%
(4,33-14,75), P=0,002). Pacijenti iz skupine dobrih spavača imali su kraću latenciju spavanja
(15 min (7-30) prema 20 min (10-45), P0,001), duže su spavali (6 h (6-7) prema 5 h (4-7),
P0,001) i ranije ustajali (6 h (6-7) prema 7 h (6-7), P=0,046) u odnosu na loše spavače.
Objektivni PSG parametri kao što su apneja-hipopneja indeks, trajanje spavanja, latencija
spavanja te udjeli pojedinih stadija spavanja ne razlikuju se značajno u skupinama dobrih i
loših spavača.
Zaključak: Ovo istraživanje je pokazalo kako žene subjektivno svoju kvalitetu spavanja
procjenjuju lošijom, imaju dužu latenciju spavanja, učestalije smetnje spavanja te češće
koriste lijekove za spavanje u odnosu na muškarce. Nadalje, muškarci imaju značajno veći
AHI i značajno manji udio stadija N3 u usporedbi sa ženama, iako je udio smanjen u oba
spola. Dobri spavači procijenili su kako brže zaspu, duže spavaju i ranije ustaju za razliku od
loših. U istraživanju nismo pronašli značajnu razliku u AHI vrijednosti i polisomnografskim
parametrima trajanja, latencije i arhitekture spavanja između dobrih i loših spavača.među dobrih i loših spavača. |
Abstract (english) | Objective: Comparison of subjective assessment of sleep quality of OSA patients and
objective indicators of whole-night polysomnography.
Subjects and methods: A total of 370 subjects, aged 20 to 82 years, participated in the study,
of which 226 men and 144 women. All subjects are patients of the Sleep Medicine Center at
the University Hospital of Split and of the University of Split School of Medicine, registered
between 2013 and 2021. The patients filled out the PSQI, ESS, and STOP questionnaires and
underwent whole-night polysomnography. Patients that had undergone polygraphy,
underaged patients, and those showing incomplete data were excluded from the analysis.
Subjective assessment of sleep quality measured by the PSQI survey was analyzed. The
subjects were divided into two groups based on the survey: good and poor sleepers.
Subjective and objective parameters were compared in men and women, and in the groups of
good and poor sleepers.
Results: Out of 370 subjects, 202 (54.59%) were categorized as “good sleepers”, while the
remaining 168 (45.41%) were categorized as “poor sleepers”. The group of good sleepers
contains significantly more men than women (133 vs. 69, P=0.039). Women obtained a
higher PSQI score compared to men (9.213.89 vs. 8.043.43, P=0.003), and had longer sleep
latency, more frequent sleep disturbances, and were taking sleep pharmacotherapy more
often. The average AHI level is significantly higher in men than women (24.2 (10.1-47.6) vs.
12.55 (4.18-33.25), P<0.001). Men spent a smaller part of the night in the N3 stage in
comparison to women (6.75% (1.53-11.9) vs. 8.65% (4.33-14.75), P=0.002). Patients from
the good-sleepers group had a shorter sleep latency (15 min (7-30) vs. 20 min (10-45),
P<0.001), slept longer (6 h (6-7) vs. 5 h (4-7), P<0.001), and woke up earlier (6 h (6-7) vs. 7 h
(6-7), P=0.046) in comparison with bad sleepers. Objective PSG parameters, such as apneahypopnea index, sleep duration, sleep latency, and percentages of certain sleep stages did not
significantly differ between the groups of good and poor sleepers.
Conclusion: This research has shown that women subjectively estimate their sleep quality as
poorer, have longer sleep latency, more frequent sleep disturbances, and take sleep
medications more often compared to men. Moreover, men have a significantly higher AHI
and a significantly lower percentage of N3 stage compared to women. Good sleepers have
estimated that they fall asleep faster, sleep longer, and wake up earlier unlike the poor
sleepers. In the research, we have not found a significant difference in AHI levels and
polysomnographic parameters of sleep duration, latency, and architecture between good and
poor sleepers. |