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[Self-assessment by patients of impairment caused by obstructive sleep apnea syndrome]
W J Randerath1, B Kroll, M Schwickert
1Klinik für Pneumologie, Allergologie und Schlafmedizin, Klinik Ambrock, Hagen, Universität Witten/Herdecke.
Background And Objective:
The compliance of the nasal continuous positive airway pressure treatment (nCPAP) of the obstructive sleep apnea syndrome (OSAS) depends on the patients' awareness and improvement of the symptoms. Therefore, we studied the relevance of OSAS in different aspects of the quality of life and important aspects of daily life (driving performance, working place).
Methods:
352 patients with OSAS filled in a questionnaire of sociodemographic data and impairment of quality of life. The relevance of OSAS was evaluated with polysomnography and parameters of daytime sleepiness.
Results:
The number of women was lower than expected from community related data. The apnea/hypopnea index was 29.9 +/- 23.4/h at baseline measurement and was reduced to 8.8 +/- 9.6/h with nCPAP (p < 0.001). The arousal index (baseline 26.6 +/- 15.3/h) fell with treatment significantly (17.7 +/- 9.2 Arousals/h, p < 0.001). The error rate in the driving simulator test was 7.8 +/- 8.9% (normal value 5.75 +/- 1.4). It was normalised with nCPAP (5.8 +/- 9.5, p < 0.001). 42.3% of patients reported about sleep apnea related symptoms for more than five years before diagnosis. The patients rated their physical fitness on a scale (0 to 6) at 2.9 +/- 1.3. It increased significantly with treatment to 3.4 +/- 1.3 an (p < 0.001). The mental activity improved significantly, too. The daytime sleepiness improved from 3.4 +/- 1.5 to 3.1 +/- 1.5 (p < 0.001). 32.3% of the patients reported that they fell asleep while steering at least once in the last month, 13.0% reported about more than five episodes/month. 5.3% of the patients thought their job in danger because of OSAS. 65.1% felt their performance in job to be impaired.
Conclusion:
OSAS impairs patients in different aspects of daily life, especially in the working place. The latency between the onset of symptoms and diagnosis is longer than expected. NCPAP treatment improves the symptoms of OSAS significantly both in criteria of polysomnography and self-assessment of the patients.