Fatigue and sleepiness determine respiratory quality of life among veterans evaluated for sleep apnea

Health and Quality of Life Outcomes

Research

Denis Vinnikov¹  Paul D. Blanc²  Alaena Alilin³  Jon-Erik C. Holty⁴  Moshe Zutler⁵ 

[1] Department of Internal Medicine, Occupational Diseases and Hematology, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan;School of Public Health, Al-Farabi Kazakh National University, Almaty, Kazakhstan;Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA;SF Veterans Affairs Medical Center, San Francisco, CA, USA;Pulmonary, Critical Care and Sleep Medicine Section, VA Palo Alto Health Care System, Palo Alto, CA, USA;Pulmonary, Critical Care and Sleep Medicine Section, VA Palo Alto Health Care System, Palo Alto, CA, USA;Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Palo Alto, CA, USA;Center for Health Policy (CHP/PCOR), Stanford University, Palo Alto, CA, USA;Starling Physicians, New Britain, CT, USA;

关键词: Quality of life;    Sleep apnea syndromes;    Lung diseases;    Disorders of excessive somnolence;    Fatigue;    Health status indicators;    Pulmonary disease;    Chronic obstructive;    Asthma;   

DOI  :  10.1186/s12955-017-0624-x

 received in 2016-09-11, accepted in 2017-03-03,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIn those with symptoms indicative of obstructive sleep apnea (OSA), respiratory-specific health-related quality of life (HRQL) may be an important patient-centered outcome. The aim of this study was to assess the associations between sleepiness, fatigue, and impaired general and respiratory-specific HRQL among persons with suspected OSA.MethodsWe evaluated military veterans consecutively referred for suspected OSA with sleep studies yielding apnea-hypopnea index (AHI) values. They also completed the sleepiness (Epworth Sleepiness Scale [ESS]), and fatigue (Fatigue Severity Scale [FSS]) questionnaires, as well as two HRQL instruments (the generic Short-Form SF-12v2 yielding the Physical Component Scale [PCS] and the respiratory-specific Airways Questionnaire [AQ]-20R). Multiple linear regression tested the associations between ESS and FSS (standardized as Z scores for scaling comparability) with AQ-20R, accounting for AHI, SF-12v2-PCS and comorbid respiratory conditions other than OSA.ResultsWe studied 1578 veterans (median age 61.1 [IQR 16.8] years; 93.9% males). Of these, 823 (52%) met AHI criteria for moderate to severe OSA (AHI ≥15/h). The majority reported excessive daytime sleepiness (53%; median ESS 11 [IQR 9]) or fatigue (61%; median FSS 42 [IQR 23]). The median AQ-20R was 4 [IQR 1–8]. Controlling for AHI, SF-12v2-PCS, respiratory co-morbid conditions, body mass index, and demographics, both ESS and FSS were significantly associated with poorer AQ-20R: for each; ESS, 1.6 points (95% CI 1.4–1.9), and for FSS, 2.5 points (95% CI, 2.3–2.7).ConclusionsGreater daytime sleepiness and fatigue are associated with poorer respiratory-specific HRQL, over and above the effects of OSA, respiratory comorbidity, and generic physical HRQL.

【 授权许可】

CC BY   
© The Author(s). 2017