| Abstract | Objectives: Obstructive sleep apnea (OSA) is a disorder characterized by repetitive
cessations of breathing during sleep. One of the most prominent symptoms of OSA is excessive
daytime sleepiness, associated with micro arousals from sleep which are caused by respiratory
events. Another feature of the OSA linked to respiratory related arousals might be impaired
sleep architecture resulting in decreased subjective sleep quality. The main aim of this research
was to assess and compare the subjective sleep quality and daytime sleepiness and objective
whole-night polysomnography findings in OSA patients.
Patients and methods: A total of 317 adult OSA patients from the Split Sleep Medicine
Center, with an age range from 18 to 82 years, were included in this study. All the patients
filled in the questionnaires: Epworth sleepiness scale (ESS), assessing daytime sleepiness, and
Pittsburgh Sleep Quality Index (PSQI), assessing subjective sleep quality. Following
completion of the questionnaires, the patients underwent whole-night polysomnography.
Results: Sleep architecture changed with OSA severity, with an increased amount of
sleep stage N2 (66.41 ± 11.93% in mild OSA, 69.12 ± 11.43% in moderate OSA and 73.45 ±
14.74% of sleep stage N2 in severe OSA, F = 8.635, P < 0.001) and decreased amount of deep
sleep stage N3 in more severe forms of OSA (11.67 ± 8.89 % in mild OSA, 11.10 ± 7.35% in
moderate OSA and 6.88 ± 7.63 in severe OSA, F = 12.701, P < 0.001). There was also a
correlation between OSA severity and excessive daytime sleepiness assessed by ESS (r = 0.25,
P < 0.001). Patients who had poorer sleep efficiency had worse subjective sleep quality
assessed by PSQI (r = -0.21, P = 0.001). There were no statistically significant differences in
sleep architecture among patients with good and bad sleep quality according to PSQI (P >
0.05), and among those with normal and excessive daytime sleepiness, according to ESS (P >
0.05).
Conclusions: The obtained results demonstrated that OSA severity was associated with
an impairment of the sleep architecture and with more pronounced excessive daytime
sleepiness. Sleep efficiency, but not the sleep architecture of OSA patients correlated with
subjective sleep quality assessed by PSQI. However, no differences in sleep architecture among
OSA patients with and without excessive daytime sleepiness assessed by ESS were found. |
| Abstract (croatian) | Ciljevi: Opstrukcijska apneja tijekom spavanja (OSA) poremećaj je obilježen
ponavljanim prekidima disanja tijekom spavanja. Jedan od najistaknutijih simptoma OSA-e je
prekomjerna dnevna pospanost, povezana s mikrobuđenjima koja su uzrokovana respiratornim
događajima. Još jedna značajka OSA-e izazvana buđenjima može biti narušena arhitektura
spavanja koja bi mogla rezultirati smanjenom subjektivnom kvalitetom spavanja. Glavni cilj
ovog istraživanja bio je procijeniti i usporediti subjektivnu kvalitetu spavanja i dnevnu
pospanost te objektivne polisomnografske nalaze u OSA bolesnika.
Pacijenti i postupci: Ukupno 317 odraslih OSA pacijenata iz splitskog Centra za
medicinu spavanja, u dobi od 18 do 82 godine, uključeno je u ovu studiju. Svi pacijenti popunili
su upitnike: Epworthovu ljestvicu pospanosti (ESS) koja procjenjuje dnevnu pospanost i
Pittsburghški indeks kvalitete spavanja (PSQI) koji procjenjuje subjektivnu kvalitetu spavanja.
Nakon popunjavanja upitnika, pacijenti su podvrgnuti cjelonoćnoj polisomnografiji.
Rezultati: Težina OSA-e utjecala je na arhitekturu spavanja, posebice povećanjem
količine N2 stadija spavanja (66,41 ± 11,93% u blagoj OSA-i, 69,12 ± 11,43% u umjerenoj
OSA-i i 73,45 ± 14,74% u teškoj OSA-i; F = 8,635, P < 0.001) i smanjenjem količine dubokog
spavanja N3 u težim oblicima OSA-e (11,67 ± 8,89% u blagoj OSA-i, 11,10 ± 7,35% u
umjerenoj OSA-i i 6,88 ± 7,63 u teškoj OSA-i; F = 12,701, P < 0.001). Postojala je i korelacija
između težine OSA-e i prekomjerne dnevne pospanosti procijenjene pomoću ESS (r = 0,25, P
< 0.001). Lošija subjektivna kvaliteta spavanja procijenjena pomoću PSQI bila je povezana s
manjom učinkovitošću spavanja (r = -0,21, P = 0,001). Nije bilo statistički značajnih razlika u
arhitekturi spavanja u bolesnika s dobrom i lošom kvalitetom spavanja prema PSQI-u (P >
0,05), te među onima s normalnom i prekomjernom dnevnom pospanošću, prema ESS-u (P >
0,05).
Zaključci: Dobiveni rezultati pokazali su da je težina OSA-e povezana s narušenom
arhitekturom spavanja i s izraženijom dnevnom pospanošću. Učinkovitost spavanja, ali ne i
arhitektura spavanja OSA bolesnika bila je u korelaciji sa subjektivnom kvalitetom spavanja
procijenjenom pomoću PSQI-ja. Međutim, nisu nađene razlike u arhitekturi spavanja u OSA
bolesnika sa i bez prekomjerne dnevne pospanosti procijenjene pomoću ESS. |
