Factors affecting fatigue severity in patients with obstructive sleep apnea

Area of Science:

• Sleep Medicine
• Pulmonology
• Neurology

Background:

• Obstructive sleep apnea (OSA) is a prevalent condition associated with various health issues.
• Fatigue is a common and debilitating symptom in OSA patients.
• Limited research has explored the specific factors contributing to fatigue severity in OSA.

Purpose of the Study:

• To investigate the factors influencing fatigue severity in patients diagnosed with obstructive sleep apnea (OSA).
• To determine the relationship between fatigue and other sleep-related parameters, including insomnia and sleepiness.

Main Methods:

• A cohort of 633 patients diagnosed with OSA via polysomnography was studied.
• Participants completed validated questionnaires assessing fatigue (Fatigue Severity Scale - FSS), sleepiness (Korean Epworth Sleepiness Scale - K-ESS), insomnia (Insomnia Severity Index - ISI), sleep quality (Korean Pittsburgh Sleep Quality Index - K-PSQI), and depression (Beck Depression Inventory-2 - BDI-2).
• Multiple regression analysis was employed to identify predictors of FSS scores.

Main Results:

• Younger age (β = -0.146, P = .005) was associated with higher fatigue severity.
• Increased sleepiness (K-ESS, β = 0.689, P < .001) and insomnia severity (ISI scores of 8-14 and ≥15, P = .006 and P = .009, respectively) were significant predictors of higher FSS scores.
• Poor sleep quality (K-PSQI, β = 0.684, P = .002) also correlated with increased fatigue. OSA severity metrics like apnea-hypopnea index (AHI) and oxygen saturation were not significantly associated with fatigue.

Conclusions:

• Fatigue severity in OSA patients is primarily associated with younger age, subjective sleepiness, and insomnia symptoms.
• The severity of OSA itself, as measured by AHI or oxygen desaturation, does not appear to be a direct predictor of fatigue.
• These findings suggest that interventions targeting sleepiness and insomnia may be crucial for managing fatigue in OSA.