scholarly journals Examining the Impact of Excessive Daytime Sleepiness on Utility Scores in Patients with Obstructive Sleep Apnoea and/or Narcolepsy in Five European Countries

2021 ◽  
Author(s):  
M. Janelle Cambron-Mellott ◽  
Sam Mettam ◽  
Vicky W. Li ◽  
John C. Rowland ◽  
JeanPierre Coaquira Castro
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnoea ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Sleep Apnoea ◽  
Obstructive Sleep ◽  
Cardinal Symptom ◽  
The Impact ◽  
Utility Scores

Abstract Background: Excessive daytime sleepiness (EDS) is a cardinal symptom of narcolepsy and affects many patients with obstructive sleep apnoea (OSA). EDS is associated with reduced quality of life, increased accident risk, and poor workplace performance. Given the impact of EDS, the ability to predict health-related utility from sleepiness is valuable for examining the cost effectiveness of novel treatments. The aim of this study was to examine the association between EDS and EQ-5D in patients with OSA and/or narcolepsy by modelling EQ-5D utility scores from Epworth Sleepiness Scale (ESS) scores.Methods: Data were obtained from the Europe 2016/2017 National Health and Wellness Survey, an online, general population survey, designed to represent the age and gender composition of each country’s adult population. Analyses included 2,348 patients self-reporting symptomatic and diagnosed OSA (n=2,277), narcolepsy (n=48), or both (n=23). Multivariable models were used to examine ESS as a predictor of EQ-5D utility while adjusting for covariates of interest. Results were validated following the National Institute for Health and Care Excellence Decision Support Unit guidelines for predictive modeling.Results: Utility decreased as EDS severity increased (no EDS: 0.711±0.251, mild: 0.685±0.261, moderate: 0.643±0.268, severe: 0.559±0.323). Whereas participants with only OSA or only narcolepsy did not differ in utility, those with both conditions had lower scores (0.685±0.266 and 0.627±0.325 vs. 0.439±0.340, respectively). Piecewise linear regression identified a single breakpoint at ESS score of 11.29. In the final model, for each point increase in ESS score, the corresponding decrease in EQ-5D utility was larger among patients with ESS scores ≥12 compared to patients with ESS scores ≤11 (model slopes: -0.0131 vs. -0.0026, respectively). Findings from the validation sample confirmed these results.Conclusions: This study demonstrates the impact of sleepiness on quality of life (QoL) and its negative impact irrespective of sleep condition (OSA or narcolepsy). The breakpoint identified is relatively consistent with the established ESS cutoff score ≥11, which demarcates pathological sleepiness. Furthermore, as EDS severity worsens (increases) on the ESS, the impact on QoL is greater.

scholarly journals Quality of life and metabolic disorders in patients with obstructive sleep apnea

2012 ◽  
Vol 35 (2) ◽  
pp. 105 ◽  
Author(s):  
Emel Bulcun ◽  
Aydanur Ekici ◽  
Mehmet Ekici
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Metabolic Disorders ◽  
Obstructive Sleep ◽  
The Impact

Purpose: Quality of life (QoL) may be poor in patients with sleep apnea depending on multifactorial reasons. In this observational study, we examined the factors determining QoL in patients with obstructive sleep apnea (OSA) and nonapneic snoring subjects. Methods: Complete assessments were obtained on 111 subjects who diagnosed OSA and 18 nonapneic snoring subjects. Fasting blood samples of all of subjects were taken to determine insulin resistance (IR) and oral glucose tolerance tests were performed to diagnose disorders of glucose metabolism (DGM). Quality of life, with short form (SF)-36, and excessive daytime sleepiness, with epwort sleepness scale (ESS), were evaluated. Results: The mean age of the patients with OSA was higher than that of the nonapneic snoring subjects (48.4 ± 9.6 years and 43.0 ± 11.8 years, respectively; p=0.03). BMI was also significantly higher in the patients with OSA than in the nonapneic snorers (31.0 ± 4.5 and 27.1 ± 4.0, respectively; p=0.001). The mental health component in the patients with OSA was slightly but not significantly lower than the nonapneic snoring subjects (p=0.05). A negative correlation among most domains of quality of life with scores of ESS, body mass index (BMI), presence of hypertension (HT) and DGM was found. Only physicial functioning was negatively correlated with apnea hypopnea index (AHI). In linear regression analysis, there were negative associations among physical functioning with BMI, presence of HT and DGM while there was no association between physicial functioning and AHI. In addition, there were negative correlations between mental health component with BMI and presence of HT in the multivariate analysis. Obese patients with OSA had lower physicial and mental components compared with nonobese patients with OSA. Conclusion: The impact of OSA on quality of life can be attributed to excessive daytime sleepiness. Obesity and metabolic disorders in patients with OSA may also negatively affect the quality of life.

scholarly journals Sleep in elite swimmers: prevalence of sleepiness, obstructive sleep apnoea and poor sleep quality

2019 ◽  
Vol 5 (1) ◽  
pp. e000673
Author(s):  
Pavol Surda ◽  
Matus Putala ◽  
Pavel Siarnik ◽  
Abigail Walker ◽  
Katherine De Rome ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Obstructive Sleep Apnoea ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Sleep Apnoea ◽  
Quality Of Sleep ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Elite Swimmers

ObjectivesLimited data suggest that swimmers might be affected by poor quality of sleep significantly. The aim was to explore the prevalence of sleep disturbances in swimmers and possible link between rhinitis and sleep disturbance.MethodsStudy 1 was an observational case–control, questionnaire-based study involving 157 elite and non-elite swimmers, 36 non-swimming athletes and 50 controls. In study 2, we measured sleep quality and duration using actigraphy in 20 elite swimmers. We also looked for presence of sleep-disordered breathing using overnight pulse oximetry monitor.ResultsIn study 1, we observed a significant difference in prevalence of excessive daytime sleepiness between groups of elite swimmers and controls. Pittsburgh Sleep Quality Index (PSQI) scores do not suggest that quality of sleep in group of swimmers is impaired. In study 2, we found that prevalence of obstructive sleep apnoea (OSA) in elite swimmers defined as oxygen desaturation index ≥5 was 30%. Analysis of actigraphy data revealed that on nights prior to training days, ‘going to’ bed time was significantly earlier and total sleep time was significantly reduced.ConclusionSwimmers and non-swimming athletes suffer significantly more with excessive daytime sleepiness than healthy controls. In elite swimmers, this is likely linked to high prevalence of OSA. PSQI scores do not suggest that quality of sleep in group of swimmers is impaired, but actigraphy shows great variations between sleep pattern preceding training and rest day. This seems to be associated with early-morning sessions which can be a disruptive element of weekly sleep patterns.

scholarly journals Impact of adenoidectomy or adenotonsillectomy on paediatric quality of life using obstructive sleep apnoea - 18 questionnaire

2020 ◽  
Vol 6 (5) ◽  
pp. 955
Author(s):  
Hemendra Bamaniya ◽  
Veena Mobarsa ◽  
H. S. Bhuie ◽  
Rajiv Kumar Saxena
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnoea ◽  
Medical Science ◽  
Sleep Apnoea ◽  
P Value ◽  
Adenoid Hypertrophy ◽  
Post Operative Period ◽  
Obstructive Sleep ◽  
The Impact

<p class="abstract"><strong>Background:</strong> Recurrent adeno-tonsillitis can lead to problems of secretory otitis media/OSA/sinusitis and thus adenotonsillectomy is one of the most frequent done surgery in children. The present study aimed to evaluate the impact of adenoidectomy or adenotonsillectomy on the quality of life of children using obstructive sleep apnoea- 18 score.</p><p class="abstract"><strong>Methods:</strong> A prospective study was conducted in the Department of Otorhinolaryngology, Head and Neck Surgery at Ananta Institute of Medical Science, Rajsamand between January 2017 to December 2019. A total of 60 patients of age group 4 to 15 years were included in study who were undergoing adenoidectomy or adenotonsillectomy. All patients were evaluated by using ‘obstructive sleep apnea - 18’ (OSA-18) preoperatively and 6 months post- operative period for impact on quality of life on children after surgery.  </p><p class="abstract"><strong>Results:</strong> 60 children with a mean age of 8.6 years were evaluated. The most frequent indication for surgery was recurrent adeno-tonsillitis and obstructive sleep apnoea for adenoid hypertrophy. The total mean score of initial OSA-18 was 85.34, following surgery at 6 months, the total mean score was reduced to 31.23 (p value &lt;0.001). Similarly, there was reduction in mean score of individual domains after surgery which was statically significant (p&lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> Our study concludes that on evaluation of children with adenoid hypertrophy using OSA-18 pre-operative and 6 months post-operative period, showed adenoidectomy or adenotonsillectomy has positive impact on paediatric quality of life.</p>

scholarly journals The association between beta-blocker therapy and daytime sleepiness in obstructive sleep apnoea

2021 ◽  
Author(s):  
Martina Meszaros ◽  
Alexander G. Mathioudakis ◽  
Maria Xanthoudaki ◽  
Victoria Sircu ◽  
Evangelia Nena ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Beta Blocker ◽  
Daytime Sleepiness ◽  
Beta Blockers ◽  
Multivariate Logistic Regression Analysis ◽  
Sleep Time ◽  
Sleep Apnoea ◽  
Sensitivity Analyses ◽  
Obstructive Sleep ◽  
Cardinal Symptom

AbstractDaytime sleepiness is a cardinal symptom of obstructive sleep apnoea (OSA) and a well-recognised side effect of beta-blockers, therefore patients with OSA under this treatment may have worse sleepiness. However, the interaction between daytime sleepiness and beta-blockers use has not been thoroughly investigated in patients with OSA before. We analysed the data of 2183 individuals (1852 patients with OSA and 331 snorer controls) from 3 countries (Greece, Hungary and Moldova). Medical history, including medication usage and the Epworth Sleepiness Scale (ESS) were recorded. Patients and controls were divided into somnolent (ESS ≥ 11) and non-somnolent (ESS < 11) groups, and the association between-blocker use with the somnolent group was investigated with multivariate logistic regression analysis adjusted for confounders. Sensitivity analyses were performed in each cohort, in the severity subgroups, in patients who did not take statins and in those who had polysomnography as a diagnostic test. There was no relationship between beta-blocker usage and the somnolent OSA (p = 0.24) or control (p = 0.64) groups. These results were similar in sensitivity analyses (all p > 0.05). ESS was related to BMI (ρ = 0.25), total sleep time (ρ = 0.07), AHI (ρ = 0.32), oxygen desaturation index (ρ = 0.33) and minimum oxygen saturation (ρ =  – 0.32, all p < 0.05) in OSA, and was higher in patients with hypertension, diabetes and cerebro/cardiovascular disease and those who took statins (all p < 0.05). In general, beta-blockers are not associated with increased daytime sleepiness in OSA. Thus, the diagnosis of OSA should not discourage initiation of beta-blocker treatment, if it is clinically indicated.

Quality of life of children with sleep-disordered breathing treated with adenotonsillectomy

2010 ◽  
Vol 125 (2) ◽  
pp. 193-198 ◽  
Author(s):  
S M Powell ◽  
M Tremlett ◽  
D A Bosman
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnoea ◽  
Sleep Disordered Breathing ◽  
Sleep Apnoea ◽  
Life Assessment ◽  
Effect Sizes ◽  
Obstructive Sleep ◽  
Disordered Breathing

AbstractObjective:To assess the quality of life of UK children with sleep-disordered breathing undergoing adenotonsillectomy, by using the Obstructive Sleep Apnoea 18 questionnaire and determining score changes and effect sizes.Design:Prospective, longitudinal study.Setting:The otolaryngology department of a university teaching hospital in Northern England.Participants:Twenty-eight children for whom adenotonsillectomy was planned as treatment for sleep-disordered breathing, and who had either a clinical history consistent with obstructive sleep apnoea or a polysomnographic diagnosis.Main outcome measure:The Obstructive Sleep Apnoea 18 questionnaire, a previously validated, disease-specific quality of life assessment tool; changes in questionnaire scores and effect sizes were assessed.Methods:The Obstructive Sleep Apnoea 18 questionnaire was administered to each child's parent pre-operatively, then again at the follow-up appointment. Questionnaire scores ranged from 1 to 7. Score changes were analysed using the paired t-test; effect sizes were calculated using 95 per cent confidence intervals.Results:Complete data were obtained for 22 children (mean age, 61 months). Ten had undergone pre-operative polysomnography. Twenty-one children underwent adenotonsillectomy (one underwent tonsillectomy). Median follow up was eight weeks (interquartile range, six to 11 weeks). Following surgery, the overall mean score improvement was 2.6 (p < 0.0001) and the mean effect size 2.4 (95 per cent confidence interval 1.9 to 2.8). There were significant improvements in each of the individual questionnaire domains, i.e. sleep disturbance (mean score change 3.9, p < 0.0001), physical suffering (2.2, p < 0.0001), emotional distress (2.0, p = 0.0001), daytime problems (1.8, p = 0.0001) and caregiver concerns (2.6, p < 0.0001).Conclusion:In these children with sleep-disordered breathing treated by adenotonsillectomy, Obstructive Sleep Apnoea 18 questionnaire results indicated significantly improved mean score changes and effect sizes across all questionnaire domains, comparing pre- and post-operative data.

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