CORELATIONSHIP BETWEEN EXCESSIVE DAYTIME SLEEPINESS AND OBSTRUCTIVE SLEEP APNEA - A POLYSOMNOGRAPHY STUDY
Journal Title: The Odisha Journal of Psychiatry - Year 2013, Vol 20, Issue 1
Abstract
Background: Excessive daytime sleepiness (EDS) is the major complaint in subjects with obstructive sleep apnea syndrome (OSAS).However, EDS is not universally present in all patients with OSAS. The mechanisms explaining why some patients with OSAS complain of EDS whereas others do not are non restorative sleep with fragmentation of sleep, microarousals, lack of slow waves and decrease in total sleep time. Objective: To investigate polysomnographic determinants of excessive daytime sleepiness (EDS) in patients with obstructive sleep apnea (OSAS). Methods: Thirty adult patients with an apnea-hypopnea index greater than 5per hour were evaluated at Sleep Disorder Clinic Cuttack. EDS was assessed using the Epworth Sleepiness Scale (ESS),and patients were considered to have EDS if the ESS was >10. Results: EDS was found to be more prevalent in males.In age group 51-60 EDS was more observed.The cases had BMI > 30kg/ m2 comparative to control BMI25kg/ m2.N eck circumference > 36.5cm and the control was33.6 cm. ESS score the gold standard for diagnosing EDS was found to be significant i.e, P <O.OOl.AHI was 38.5/hr in cases compared to control 2jhr&P<O.001. Mean O2 saturation was observed to be 88%in patients and control showed 97%.Conclusion: EDS in OSA seems almost independent of prior night sleep. Furthermore, objective and subjective variables of EDS were studied. These results could be due to: (i) an arbitrarily defined criterion of ESS as an indicator of severity; (U)a nonlinear development of subjective and objective EDS in OSA; (iii)intruding factors of motivation, ability of self-reflection, self-rating and illnessjudgement; and (iv) a deficit of adequate measurements for night sleep and daytime function.
Authors and Affiliations
Dr. Rashmi Rani Dash, Dr. Arpita Priyadarshini, Dr. Biswaranjan Nayak
Keywords
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