폐쇄성 수면무호흡증 환자의 주간 졸림증 및 불면증에 대한 임상 분석

Abstract

Background and Objectives: Sleep disturbances and excessive daytime sleepiness (EDS) are the major symptoms of obstructivesleep apnea (OSA). This study aimed to investigate clinical implications of insomnia and EDS in patients with OSAusing the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS).

Materials and Method: We evaluated 131 subjects with suspected OSA who were undergoing polysomnography (PSG)and performing the PSQI and ESS surveys. OSA was diagnosed when the apnea-hypopnea index was five or more. EDS wasdefined when ESS score was 11 points or higher. Detailed history and questionnaire were used to categorize insomnia. We comparedclinical variables and PSG results in subgroups with or without insomnia and EDS.

Results: There were no significant differences of PSQI and ESS score between controls and OSA. OSA with insomnia hadsignificantly increased total score (p<0.001) and decreased total sleep time (p=0.001) and sleep efficiency (p=0.001) on thePSQI compared to those without insomnia. OSA with EDS showed significantly increased PSQI score (p=0.022) and decreasedtotal sleep time (p=0.018) on PSG compared to those without EDS. Neither PSQI nor ESS score had a correlation with respiratoryvariables such as AHI and oxygen saturation. Total sleep time had a significant effect on both insomnia and EDS in patientswith OSA.

Conclusion: Decreased total sleep time had important effects on subjective symptoms of OSA and comorbid insomnia. Therefore,restoration of decreased sleep time is important in the management of OSA.