Chest
Clinical InvestigationsPredictors of Objective Level of Daytime Sleepiness in Patients with Sleep-Related Breathing Disorders
Section snippets
Subjects
The subjects of this report are 466 patients, 415 men and 51 women, (mean age, 52.5 ± 12.2 years), who underwent diagnostic evaluation for sleep apnea at the Henry Ford Hospital Sleep Disorders Center. Each had a complete evaluation, including a nocturnal polysomnogram and a MSLT.
Procedure
For the diagnostic evaluation, patients completed a questionnaire on sleep disorders before their first clinic visit, which detailed the symptoms and history of their sleep complaint. During the clinical interview, the
RESULTS
The demographic characteristics and descriptive measures of the nocturnal sleep and respiratory disturbance of this sample of apneic patients is presented in Tables 1 and 2. The data presented include means, SDs, and CVs. The CV is a measure of the ratio of the mean to the SD which facilitates comparisons of variability among parameters. Variability is desirable in correlation and regression analyses; reduced variability limits the potential size of a correlation. The oximetric parameters
DISCUSSION
These data support the sleep fragmentation hypothesis which states that the daytime sleepiness of patients with OSAS is due to the disruption of sleep by brief electroencephalographic arousals accompanying the cessation of an apnea or hypopnea. These findings do not refute the association of hypoxemia with daytime sleepiness in apneic patients. In fact, the data of this study showed that hypoxemia and daytime sleepiness are correlated; however, these data do indicate that the correlation of
ACKNOWLEDGMENTS
We thank Dr. Meir Kryger for his thoughtful review of an earlier version of this report.
REFERENCES (16)
- et al.
Hypersomnolent and nonhypersomnolent patients with upper airway obstruction during sleep
Chest
(1979) - et al.
Self-reported excessive daytime somnolence and impaired respiration in sleep
Chest
(1986) - et al.
Determinants of daytime sleepiness in obstructive sleep apnea
Chest
(1988) - et al.
Sleep apnea syndromes and related sleep disorders
- et al.
Sleep apnea syndrome due to upper airway obstruction
Arch Intern Med
(1977) - et al.
Mantovani M: Hypersomnia with periodic apneas
(1978) - et al.
Multiple naps and the evaluation of daytime sleepiness in patients with upper airway sleep apnea
Sleep
(1980) - et al.
Sleep fragmentation and daytime sleepiness
Sleep
(1984)
Cited by (220)
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2020, Clinical Neurophysiology
†Supported by grant R01 NS22758-03.
Manuscript received October 3; revision accepted October 25.