Do Obstructive Sleep Apnea Syndrome Patients Underestimate Their Daytime Symptoms Before Continuous Positive Airway Pressure Treatment?

Overview

Journal Can Respir J

Publisher Wiley

Specialty Pulmonary Medicine

Date 2014 Apr 9

PMID 24712013

Citations 7

Authors

Gabrielle Leclerc

Yves Lacasse

Diane Page

Frederic Series

Affiliations

Soon will be listed here.

Abstract

Background: Daytime somnolence is an important feature of the obstructive sleep apnea (OSA) hypopnea syndrome and is usually subjectively assessed using the Epworth Sleepiness Scale (ESS).

Objective: To compare the scores of the ESS and different domains of the Quebec Sleep Questionnaire (QSQ) assessed before and after the first months of continuous positive airway pressure (CPAP) treatment, as well as retrospectively without treatment.

Methods: The ESS score and domain scores of the QSQ were obtained before and after a three-month period of CPAP treatment using a retrospective assessment of the pretreatment scores in 76 untreated OSA patients.

Results: Fifty-two patients completed the study. The ESS and QSQ scores significantly improved following CPAP therapy. Retrospective evaluation of the ESS score was significantly worse than pre- and post-treatment values (mean [± SD] pretreatment score 11.0±4.8; retrospective pretreatment score 13.5±5.1). Such differences were not observed in any domain of the QSQ, including the domain assessing hypersomnolence.

Conclusion: OSA patients underestimated their sleepiness according to the most widely used instrument to assess hypersomnolence. This finding may not be observed with other methods used to assess OSA-related symptoms such as quality of life questionnaires.

Citing Articles

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Is the Epworth Sleepiness scale a valid outcome measure to evaluate the effectiveness of positive airway pressure treatments on daytime sleepiness? Psychometric insights from measurement invariance and response shifts.

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References

Zimmermann C, Kohler D, Schonhofer B . [Value of retrospective assessment of the Epworth Sleepiness Scale after long-term CPAP therapy in obstructive sleep apnea disorder]]. Pneumologie. 2001; 54(12):572-4. DOI: 10.1055/s-2000-9193. View

Rahaghi F, Basner R . Delayed Diagnosis of Obstructive Sleep Apnea: Don't Ask, Don't Tell. Sleep Breath. 2002; 3(4):119-124. DOI: 10.1007/s11325-999-0119-z. View

Smith S, Oei T, Douglas J, Brown I, Jorgensen G, Andrews J . Confirmatory factor analysis of the Epworth Sleepiness Scale (ESS) in patients with obstructive sleep apnoea. Sleep Med. 2007; 9(7):739-44. DOI: 10.1016/j.sleep.2007.08.004. View

Pamidi S, Knutson K, Ghods F, Mokhlesi B . Depressive symptoms and obesity as predictors of sleepiness and quality of life in patients with REM-related obstructive sleep apnea: cross-sectional analysis of a large clinical population. Sleep Med. 2011; 12(9):827-31. DOI: 10.1016/j.sleep.2011.08.003. View

Ip S, DAmbrosio C, Patel K, Obadan N, Kitsios G, Chung M . Auto-titrating versus fixed continuous positive airway pressure for the treatment of obstructive sleep apnea: a systematic review with meta-analyses. Syst Rev. 2012; 1:20. PMC: 3351715. DOI: 10.1186/2046-4053-1-20. View

Hayashida K, Inoue Y, Chiba S, Yagi T, Urashima M, Honda Y . Factors influencing subjective sleepiness in patients with obstructive sleep apnea syndrome. Psychiatry Clin Neurosci. 2007; 61(5):558-63. DOI: 10.1111/j.1440-1819.2007.01707.x. View

Lacasse Y, Godbout C, Series F . Health-related quality of life in obstructive sleep apnoea. Eur Respir J. 2002; 19(3):499-503. DOI: 10.1183/09031936.02.00216902. View

Lattimore J, Celermajer D, Wilcox I . Obstructive sleep apnea and cardiovascular disease. J Am Coll Cardiol. 2003; 41(9):1429-37. DOI: 10.1016/s0735-1097(03)00184-0. View

Kaminska M, Jobin V, Mayer P, Amyot R, Perraton-Brillon M, Bellemare F . The Epworth Sleepiness Scale: self-administration versus administration by the physician, and validation of a French version. Can Respir J. 2010; 17(2):e27-34. PMC: 2866221. DOI: 10.1155/2010/438676. View

10.

Mulgrew A, Fox N, Ayas N, Ryan C . Diagnosis and initial management of obstructive sleep apnea without polysomnography: a randomized validation study. Ann Intern Med. 2007; 146(3):157-66. DOI: 10.7326/0003-4819-146-3-200702060-00004. View

11.

Nguyen A, Baltzan M, Small D, Wolkove N, Guillon S, Palayew M . Clinical reproducibility of the Epworth Sleepiness Scale. J Clin Sleep Med. 2007; 2(2):170-4. View

12.

Basoglu O, Sarac F, Sarac S, Uluer H, Yilmaz C . Metabolic syndrome, insulin resistance, fibrinogen, homocysteine, leptin, and C-reactive protein in obese patients with obstructive sleep apnea syndrome. Ann Thorac Med. 2011; 6(3):120-5. PMC: 3131753. DOI: 10.4103/1817-1737.82440. View

13.

Lacasse Y, Bureau M, Series F . A new standardised and self-administered quality of life questionnaire specific to obstructive sleep apnoea. Thorax. 2004; 59(6):494-9. PMC: 1747023. DOI: 10.1136/thx.2003.011205. View

14.

Flemons W, Reimer M . Development of a disease-specific health-related quality of life questionnaire for sleep apnea. Am J Respir Crit Care Med. 1998; 158(2):494-503. DOI: 10.1164/ajrccm.158.2.9712036. View

15.

DAmbrosio C, Bowman T, Mohsenin V . Quality of life in patients with obstructive sleep apnea: effect of nasal continuous positive airway pressure--a prospective study. Chest. 1999; 115(1):123-9. DOI: 10.1378/chest.115.1.123. View

16.

Mazza S, Pepin J, Naegele B, Plante J, Deschaux C, Levy P . Most obstructive sleep apnoea patients exhibit vigilance and attention deficits on an extended battery of tests. Eur Respir J. 2005; 25(1):75-80. DOI: 10.1183/09031936.04.00011204. View

17.

Berry R, Hill G, Thompson L, McLaurin V . Portable monitoring and autotitration versus polysomnography for the diagnosis and treatment of sleep apnea. Sleep. 2008; 31(10):1423-31. PMC: 2572748. View

18.

Holmdahl C, Schollin I, Alton M, Nilsson K . CPAP treatment in obstructive sleep apnoea: a randomised, controlled trial of follow-up with a focus on patient satisfaction. Sleep Med. 2009; 10(8):869-74. DOI: 10.1016/j.sleep.2008.08.008. View

19.

Avlonitou E, Kapsimalis F, Varouchakis G, Vardavas C, Behrakis P . Adherence to CPAP therapy improves quality of life and reduces symptoms among obstructive sleep apnea syndrome patients. Sleep Breath. 2011; 16(2):563-9. DOI: 10.1007/s11325-011-0543-8. View

20.

Lee S, Kang H, Lee L . The relationship between the Epworth Sleepiness Scale and polysomnographic parameters in obstructive sleep apnea patients. Eur Arch Otorhinolaryngol. 2011; 269(4):1143-7. DOI: 10.1007/s00405-011-1808-3. View