scholarly journals Excessive Daytime Sleepiness in Depression and Obstructive Sleep Apnea: More Than Just an Overlapping Symptom

2021 ◽  
Vol 12 ◽  
Author(s):  
Danwei Zhang ◽  
Zhen Zhang ◽  
Huihua Li ◽  
Kaimo Ding

Excessive daytime sleepiness (EDS) is a significant public health concern, with obstructive sleep apnea (OSA) being a common cause, and a particular relationship exists with the severity of depression. A literature search on OSA, depression, and EDS was performed in PubMed. The chosen evidence was limited to human studies. Available evidence was systematically reviewed to ascertain the association of EDS with depression and OSA according to the general population and some specific population subgroups. In addition, effectiveness of continuous positive airway pressure (CPAP) was analyzed as a standard therapy for improving EDS and depression in patients with OSA. In the general population, patients with OSA, and some other subpopulations, the review contributed to: (1) delineating the prevalence of EDS; (2) substantiating the relationship of EDS and depression; (3) presenting the relationship between EDS and OSA; and (4) revealing that the duration of CPAP is crucial for its therapeutic effects in improving EDS and depressive symptoms in patients with OSA.

2017 ◽  
Vol 2 (1) ◽  

Introduction: Obstructive sleep apnea syndrome (OSAS) is the most common sleep-related respiratory disorder. With the purpose of assisting in the screening or evaluation of OSAS patients, some scales and questionnaires were proposed. Objective: To evaluate and critically compare the relationship of excessive daytime sleepiness with the presence or absence of OSAS, in addition to other polysomnographic data. Material and method: Systematic review of the literature. Results: Six studies were included, with a total of 4258 patients; four studies demonstrate association between the Epworth sleepiness scale and the hypopnea apnea index (AIH); of those, two studies showed significant differences between ESS score and OSAS severity. Five studies (4233 patients) demonstrated lower minimum oxygen saturation in the group with excessive daytime sleepiness. There was an increase in sleep efficiency in in patients with excessive daytime sleepiness, as per the results of 3 studies (3002 patients). Discussion: The relationship between the presence of excessive daytime sleepiness and OSAS is still questioned, and its pathophysiological mechanism uncertain. Excessive daytime sleepiness secondary to OSAS seems to be an independent event, related to nocturnal hypoxemia and sleep fragmentation. Conclusion: The confidence intervals obtained from these studies do not provide clinical safety to use the Epworth sleepiness scale for screening or stratifying the risk of patients suspected of having sleep apnea.


2019 ◽  
Vol 63 ◽  
pp. 16-20
Author(s):  
HMK Murthy ◽  
SS Mohapatra

Background: Obstructive sleep apnea (OSA) is a condition resulting in disrupted sleep and excessive daytime sleepiness/somnolence (EDS) with demonstrable deficits in cognitive and psychomotor performance. Indian studies have shown the prevalence of 4.9–19.7% in males and 2.1–7.4% in females. Prevalence among military aviators is unknown. Materials and Methods: EDS was determined by employing Epworth Sleepiness Scale (ESS) among the 54 male aircrews in an airbase. The risk for OSA was also determined among these individuals using STOP-BANG questionnaire. Results and Discussion: It was found that none of the aircrews in the study group is found to have dangerously sleepy (DS). About 11.11% of the studied population were found to have EDS which is less than the prevalence rate in India as per a study conducted by the National Institute of Mental Health and Neuro Sciences on general population and the Western world (prevalence rate of 16.7%) as found by Gislason et al. OSA risk among the study population was (n = 9/54) 16.16%. The prevalence of OSA in India male is reported as 4.9–17.9%. Thus, percentage of aircrew showing the risk for OSA in this cross-sectional study is comparable with the general population in India. However, no correlation was found between the risk factors of OSA with ESS. The reasons for EDS could be attributed to factors such as personal lifestyle, sleeping habits, and poor work-rest schedules. It is interesting to note that none of the aircrew, who is positive for OSA risk, is showing EDS/DS. This further confirms that OSA risk individuals may not have EDS/DS and this could be a reason why, OSA largely remains underdiagnosed and untreated in clinical practice. Conclusion: This cross-sectional study has brought the conclusion that both EDS and risk for OSA coexists even in a fit and healthy population of aircrew.


Sleep Science ◽  
2016 ◽  
Vol 9 (2) ◽  
pp. 106-111 ◽  
Author(s):  
Michael B. Fawale ◽  
Olanrewaju Ibigbami ◽  
Ishaq Ismail ◽  
Adekunle F. Mustapha ◽  
Morenikeji A. Komolafe ◽  
...  

2021 ◽  
Vol 10 (15) ◽  
pp. 3413
Author(s):  
Afrouz Behboudi ◽  
Tilia Thelander ◽  
Duygu Yazici ◽  
Yeliz Celik ◽  
Tülay Yucel-Lindberg ◽  
...  

Obstructive sleep apnea (OSA) is common in patients with coronary artery disease (CAD), in which inflammatory activity has a crucial role. The manifestation of OSA varies significantly between individuals in clinical cohorts; not all adults with OSA demonstrate the same set of symptoms; i.e., excessive daytime sleepiness (EDS) and/or increased levels of inflammatory biomarkers. The further exploration of the molecular basis of these differences is therefore essential for a better understanding of the OSA phenotypes in cardiac patients. In this current secondary analysis of the Randomized Intervention with Continuous Positive Airway Pressure in CAD and OSA (RICCADSA) trial (Trial Registry: ClinicalTrials.gov; No: NCT 00519597), we aimed to address the association of tumor necrosis factor alpha (TNF-α)-308G/A gene polymorphism with circulating TNF-α levels and EDS among 326 participants. CAD patients with OSA (apnea–hypopnea-index (AHI) ≥ 15 events/h; n = 256) were categorized as having EDS (n = 100) or no-EDS (n = 156) based on the Epworth Sleepiness Scale score with a cut-off of 10. CAD patients with no-OSA (AHI < 5 events/h; n = 70) were included as a control group. The results demonstrated no significant differences regarding the distribution of the TNF-α alleles and genotypes between CAD patients with vs. without OSA. In a multivariate analysis, the oxygen desaturation index and TNF-α genotypes from GG to GA and GA to AA as well as the TNF-α-308A allele carriage were significantly associated with the circulating TNF-α levels. Moreover, the TNF-α-308A allele was associated with a decreased risk for EDS (odds ratio 0.64, 95% confidence interval 0.41–0.99; p = 0.043) independent of age, sex, obesity, OSA severity and the circulating TNF-α levels. We conclude that the TNF-α-308A allele appears to modulate circulatory TNF-α levels and mitigate EDS in adults with CAD and concomitant OSA.


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