Document Detail

Lack of regular exercise, depression, and degree of apnea are predictors of excessive daytime sleepiness in patients with sleep apnea: sex differences.
MedLine Citation:
PMID:  18350958     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Apnea, depression, and metabolic abnormalities are independent predictors of excessive daytime sleepiness (EDS) in patients with sleep apnea. Exercise is beneficial for apnea, depression, and metabolic abnormalities; however, its association with EDS is not known.
STUDY OBJECTIVES: To evaluate the contribution of lack of regular exercise, depression, and apnea severity on daytime sleepiness in patients with sleep apnea.
PARTICIPANTS AND DESIGN: One thousand one hundred six consecutive patients (741 men and 365 women) referred to the sleep disorders clinic for symptoms consistent with sleep apnea. Daytime sleepiness was assessed with the Epworth Sleepiness Scale and activity was evaluated with a quantifiable Physical Activity Questionnaire.
RESULTS: Compared with women, men had a higher apnea hypopnea index (AHI) (40.4 +/- 1.2 vs 31.0 +/- 1.8), lower body mass index (BMI) (35.3 +/- 0.3 kg/m2 vs 39.6 +/- 0.5 kg/m2), and higher rate of regular exercise (39.1% vs 28.8%) ( p < 0.05). Linear regression analysis of the total sample after adjusting for age, BMI, sex, central nervous system medication, and diabetes showed that logAHI, depression, and lack of regular exercise were significant predictors of sleepiness. Predictors of mild or moderate sleepiness for both sexes were depression and logAHI, whereas predictors of severe sleepiness for men were lack of regular exercise, depression, and minimum SaO2 and, for women, logAHI.
CONCLUSIONS: In obese apneic patients, lack of regular exercise (only in men), depression, and degree of apnea are significant predictors of EDS. This association is modified by sex and degree of sleepiness. Assessment and management of depression and physical exercise should be part of a thorough evaluation of patients with sleep apnea.
Maria Basta; Hung-Mo Lin; Slobodanka Pejovic; Alexios Sarrigiannidis; Edward Bixler; Alexandros N Vgontzas
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine     Volume:  4     ISSN:  1550-9389     ISO Abbreviation:  J Clin Sleep Med     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-03-20     Completed Date:  2008-05-16     Revised Date:  2013-06-05    
Medline Journal Info:
Nlm Unique ID:  101231977     Medline TA:  J Clin Sleep Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  19-25     Citation Subset:  IM    
Sleep Research and Treatment Center, Department of Psychiatry, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.
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MeSH Terms
Activities of Daily Living / psychology
Body Mass Index
Depression / complications,  diagnosis*,  epidemiology,  psychology
Diabetes Mellitus, Type 2 / complications,  diagnosis,  epidemiology
Disorders of Excessive Somnolence / diagnosis*,  epidemiology,  psychology
Energy Metabolism
Middle Aged
Retrospective Studies
Risk Factors
Sex Factors
Sleep Apnea, Obstructive / diagnosis*,  epidemiology,  psychology
Grant Support
R01 64415//PHS HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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