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The sleep/wake habits of patients diagnosed as having obstructive sleep apnea
L Rosenthal1, C Bishop, P Guido
1Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, MI 48202, USA.
Study Objective:
To determine the sleep/wake habits of patients diagnosed as having obstructive sleep apnea (ie, respiratory event index [REI] > or = 5).
Design:
Case series with prospective data collection to determine the relationship among sleepiness, REI, and sleep/wake habits. Patients were grouped according to their multiple sleep latency test (MSLT) results (< or = 5 and > 5) and REI (mild REI < or = 20; moderate REI > 20 but < or = 60; and severe REI > 60).
Setting:
An American Sleep Disorders Association-accredited sleep laboratory.
Patients:
Three hundred ninety (325 male, 65 female) consecutive patients seen between June 1993 and January 1995 for evaluation of sleep apnea. This included a sleep, medical, and psychiatric evaluation followed by a physical examination. Sleep histories and sleep/wake habits were recorded by a physician trained in sleep medicine. Polysomnographic evaluation consisted of a nocturnal clinical polysomnogram (CPSG) and an MSLT on the following day. Of 390 patients, 268 completed polysomnographic evaluation (CPSG and MSLT).
Measurements And Results:
Sleepy (MSLT < or = 5) patients with mild (REI < or = 20) and moderate apnea (REI > 20 < or = 60) reported spending significantly less time in bed than sleepy patients with severe apnea (REI > 60). Those with severe apnea (REI > 60) reported napping significantly more and experienced a more severe disruption of their routine daily activities because of sleepiness when compared with mild and moderate OSA patients.
Conclusions:
These data suggest that sleep habits have an important modulatory effect on the level of sleepiness and this effect is lost as the severity of sleep-disordered breathing increases.