Polysomnographic characteristics of daytime sleepiness in obstructive sleep apnea syndrome.
Summary of "Polysomnographic characteristics of daytime sleepiness in obstructive sleep apnea syndrome."
PURPOSE:
The study is intended to explore the nocturnal sleep determinants for excessive daytime sleepiness (EDS) in patients with obstructive sleep apnea syndrome (OSAS).
METHODS:
Consecutive patients (n = 182) who had an apnea/hypopnea index (AHI) greater than 5 times per hour were used in this study. EDS (n = 32) was considered present whenever the Epworth sleepiness scale (ESS) score was >10 and the multiple sleep latency test (MSLT) score was <5 min. Absence of EDS (no EDS, n = 48) was determined in patients with an ESS score of <10 and a MSLT score of >10 min.
RESULTS:
Compared to no EDS patients, EDS patients exhibited (1) greater AHI and time length of SaO(2) <95%, lower nocturnal SaO(2) during separate rapid eye movement (REM) and NREM periods, and lower total mean and minimum SaO(2) during total recording period; (2) shortened latency to sleep and to REM sleep, and increased total sleep time and sleep efficiency; and (3) increases in the brief arousal index and duration of sleep stage 1. In addition, stepwise logistic regression analysis showed that the arousal index, the time length of SaO(2) <95%, and the latency to REM were independent predictors of EDS.
CONCLUSIONS:
The results suggest that EDS in OSAS patients are characterized by the following aspects of nocturnal sleep: (1) severe sleep apnea/hypopnea and hypoxemia, (2) fragmented sleep, (3) low quality of sleep, and (4) high pressure of sleep drive.
Affiliation
Sleep Medicine Center, Department of Psychiatry, Department of Otolaryngology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Journal Details
This article was published in the following journal.
Name: Sleep & breathing = Schlaf & Atmung
ISSN: 1522-1709
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21465092
- DOI: http://dx.doi.org/10.1007/s11325-011-0515-z
Medical and Biotech [MESH] Definitions
Sleep Apnea, Central
A condition associated with multiple episodes of sleep apnea which are distinguished from obstructive sleep apnea (SLEEP APNEA, OBSTRUCTIVE) by the complete cessation of efforts to breathe. This disorder is associated with dysfunction of central nervous system centers that regulate respiration. This condition may be idiopathic (primary) or associated with lower brain stem lesions; chronic obstructive pulmonary disease (LUNG DISEASES, OBSTRUCTIVE); HEART FAILURE, CONGESTIVE; medication effect; and other conditions. Sleep maintenance is impaired, resulting in daytime hypersomnolence. Primary central sleep apnea is frequently associated with obstructive sleep apnea. When both forms are present the condition is referred to as mixed sleep apnea (see SLEEP APNEA SYNDROMES). (Adams et al., Principles of Neurology, 6th ed, p395; Neurol Clin 1996;14(3):611-28)
Sleep Apnea Syndromes
Disorders characterized by multiple cessations of respirations during sleep that induce partial arousals and interfere with the maintenance of sleep. Sleep apnea syndromes are divided into central (see SLEEP APNEA, CENTRAL), obstructive (see SLEEP APNEA, OBSTRUCTIVE), and mixed central-obstructive types.
Sleep Apnea, Obstructive
A disorder characterized by recurrent apneas during sleep despite persistent respiratory efforts. It is due to upper airway obstruction. The respiratory pauses may induce HYPERCAPNIA or HYPOXIA. Cardiac arrhythmias and elevation of systemic and pulmonary arterial pressures may occur. Frequent partial arousals occur throughout sleep, resulting in relative SLEEP DEPRIVATION and daytime tiredness. Associated conditions include OBESITY; ACROMEGALY; MYXEDEMA; micrognathia; MYOTONIC DYSTROPHY; adenotonsilar dystrophy; and NEUROMUSCULAR DISEASES. (From Adams et al., Principles of Neurology, 6th ed, p395)
Obesity Hypoventilation Syndrome
HYPOVENTILATION syndrome in very obese persons with excessive ADIPOSE TISSUE around the ABDOMEN and DIAPHRAGM. It is characterized by diminished to absent ventilatory chemoresponsiveness; chronic HYPOXIA; HYPERCAPNIA; POLYCYTHEMIA; and long periods of sleep during day and night (HYPERSOMNOLENCE). It is a condition often related to OBSTRUCTIVE SLEEP APNEA but can occur separately.
Hypersomnolence, Idiopathic
A sleep disorder of central nervous system origin characterized by prolonged nocturnal sleep and periods of daytime drowsiness. Affected individuals experience difficulty with awakening in the morning and may have associated sleep drunkenness, automatic behaviors, and memory disturbances. This condition differs from narcolepsy in that daytime sleep periods are longer, there is no association with CATAPLEXY, and the multiple sleep latency onset test does not record sleep-onset rapid eye movement sleep. (From Chokroverty, Sleep Disorders Medicine, 1994, pp319-20; Psychiatry Clin Neurosci 1998 Apr:52(2):125-129)
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