Journal of Rhinology

Korean Rhinologic Society (대한비과학회)
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Clinical Analysis of Daytime Sleepiness and Insomnia in Patients with Obstructive Sleep Apnea

폐쇄성 수면무호흡증 환자의 주간 졸림증 및 불면증에 대한 임상 분석

  • Kim, In Sik (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University) ;
  • Eom, Ji Hun (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University) ;
  • Yoon, Hyung Joon (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University) ;
  • Kim, Dong Hwan (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University) ;
  • Kim, Kyung Rae (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University) ;
  • Cho, Seok Hyun (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University)
  • 김인식 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 엄지훈 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 윤형준 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 김동환 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 김경래 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 조석현 (한양대학교 의과대학 이비인후-두경부외과학교실)
  • Received : 2017.06.28
  • Accepted : 2017.10.19
  • Published : 2018.11.30
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Abstract

Background and Objectives: Sleep disturbances and excessive daytime sleepiness (EDS) are the major symptoms of obstructive sleep apnea (OSA). This study aimed to investigate clinical implications of insomnia and EDS in patients with OSA using 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 was defined when ESS score was 11 points or higher. Detailed history and questionnaire were used to categorize insomnia. We compared clinical 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 had significantly increased total score (p<0.001) and decreased total sleep time (p=0.001) and sleep efficiency (p=0.001) on the PSQI compared to those without insomnia. OSA with EDS showed significantly increased PSQI score (p=0.022) and decreased total sleep time (p=0.018) on PSG compared to those without EDS. Neither PSQI nor ESS score had a correlation with respiratory variables such as AHI and oxygen saturation. Total sleep time had a significant effect on both insomnia and EDS in patients with 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.

Keywords

References

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