Kristin Marie Hoven, Hans-Jørgen Aarstad, Svein Erik Moe, Sverre K Steinsvåg
{"title":"Reported daytime sleepiness in relation to orthopnea, restless legs and nocturia in patients evaluated for suspected obstructive sleep apnea.","authors":"Kristin Marie Hoven, Hans-Jørgen Aarstad, Svein Erik Moe, Sverre K Steinsvåg","doi":"10.1007/s11325-025-03312-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study is to explore the extent to which daytime sleepiness in patients with suspected Obstructive Sleep Apnea (OSA) was correlated with OSA itself and OSA-related comorbidities and symptoms.</p><p><strong>Methods: </strong>1,305 consecutive patients undergoing OSA workup were included. They underwent standard respiratory polygraphy during sleep and completed a 19-item questionnaire about sleep-related symptoms and signs, as well as the Epworth Sleepiness Scale (ESS). Analyses were based on questionnaire responses and the Apnea-Hypopnea Index (AHI) results and were conducted using stepwise regression analysis.</p><p><strong>Results: </strong>Using the ESS as the dependent variable, the strongest associations were found with self-reported orthopnea (7%) and restless legs (2%). For daytime sleepiness, self-reported restless legs accounted for 7,6% of the variance, followed by reported orthopnea (3.8%). Regarding daytime irritability, self-reported restless legs accounted for 7.7%, followed by age (4.4%), reported orthopnea (3%), and nocturia (1%) as significant factors. Reported likelihood of falling asleep while driving was best associated with the severity of self-reported restless legs (1,3%), orthopnea (0.6%), and patient age (0.4%). For work performance, restless legs were the strongest predictor (5.9%), followed by age (3.6%) and orthopnea (3%). AHI emerged as a significant explanatory factor regarding ESS score (1.7%) and falling asleep as driver (0.4%) when analyzing the above-mentioned variables.</p><p><strong>Conclusion: </strong>Daytime sleepiness-associated symptoms were more strongly correlated with reported levels of restless legs, nocturia, and orthopnea than with the AHI score. If restless legs, orthopnea, or nocturia are present, they should be evaluated during the clinical workup for suspected OSA.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":"29 2","pages":"140"},"PeriodicalIF":2.0000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946997/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep and Breathing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11325-025-03312-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The aim of the study is to explore the extent to which daytime sleepiness in patients with suspected Obstructive Sleep Apnea (OSA) was correlated with OSA itself and OSA-related comorbidities and symptoms.
Methods: 1,305 consecutive patients undergoing OSA workup were included. They underwent standard respiratory polygraphy during sleep and completed a 19-item questionnaire about sleep-related symptoms and signs, as well as the Epworth Sleepiness Scale (ESS). Analyses were based on questionnaire responses and the Apnea-Hypopnea Index (AHI) results and were conducted using stepwise regression analysis.
Results: Using the ESS as the dependent variable, the strongest associations were found with self-reported orthopnea (7%) and restless legs (2%). For daytime sleepiness, self-reported restless legs accounted for 7,6% of the variance, followed by reported orthopnea (3.8%). Regarding daytime irritability, self-reported restless legs accounted for 7.7%, followed by age (4.4%), reported orthopnea (3%), and nocturia (1%) as significant factors. Reported likelihood of falling asleep while driving was best associated with the severity of self-reported restless legs (1,3%), orthopnea (0.6%), and patient age (0.4%). For work performance, restless legs were the strongest predictor (5.9%), followed by age (3.6%) and orthopnea (3%). AHI emerged as a significant explanatory factor regarding ESS score (1.7%) and falling asleep as driver (0.4%) when analyzing the above-mentioned variables.
Conclusion: Daytime sleepiness-associated symptoms were more strongly correlated with reported levels of restless legs, nocturia, and orthopnea than with the AHI score. If restless legs, orthopnea, or nocturia are present, they should be evaluated during the clinical workup for suspected OSA.
期刊介绍:
The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep.
Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.