Objective, but not subjective, daytime sleepiness predicts mortality in obstructive sleep apnea.

IF 4.9 2区医学 Q1 Medicine

Sleep Pub Date : 2025-09-09 DOI:10.1093/sleep/zsaf138

Yanyuan Dai, Alexandros N Vgontzas, Baixin Chen, Le Chen, Jun Wu, Dandan Zheng, Yun Li

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引用次数: 0

Abstract

Study objectives: Obstructive sleep apnea (OSA) with objective but not subjective excessive daytime sleepiness (EDS) has been reported to be associated with cardiovascular comorbidity. We aimed to investigate the association between OSA with objective or subjective EDS and mortality in a general population sample.

Methods: In this retrospective cohort study, we included 244 subjects with OSA and 553 subjects without OSA with a median follow-up duration of 8 years. Objective EDS was defined based on a mean latency value of the multiple sleep latency test (MSL) ≤ 8 min. Subjective EDS was defined based on the total score of the Epworth Sleepiness Scale > 10.

Results: After adjusting for potential confounders, OSA with objective EDS was associated with an approximately 2.5-fold higher risk of all-cause mortality (hazard ratio [HR] = 2.451, 95% confidence interval [95% CI] = 1.319 to 4.556) and 3.9-fold higher risk of CVD mortality (HR = 3.876, 95% CI = 1.293 to 11.622) compared to subjects without OSA or objective EDS. Furthermore, subjects with OSA, objective EDS, and CVD at baseline had about a 2.9-fold higher risk of all-cause mortality (HR = 2.872, 95% CI = 1.186 to 6.953) compared to subjects without OSA, objective EDS, or CVD at baseline. In contrast, OSA with subjective EDS was not associated with increased hazard of all cause or CVD mortality.

Conclusions: Objective EDS appears to be an important marker of the biological severity of OSA. Future studies to validate the findings in diverse populations and interventional studies are needed.

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客观而非主观的白天嗜睡预测阻塞性睡眠呼吸暂停的死亡率。

研究目的：阻塞性睡眠呼吸暂停（OSA）伴客观而非主观的日间过度嗜睡（EDS）已被报道与心血管合并症相关。我们的目的是在一般人群样本中调查OSA与客观或主观EDS和死亡率之间的关系。方法：在这项回顾性队列研究中，我们纳入了244例OSA患者和553例非OSA患者，中位随访时间为8年。目的根据多次睡眠潜伏期测试（MSL）的平均潜伏期值≤8分钟来定义EDS。主观睡眠缺失是根据Epworth嗜睡量表（ESS） bbbb10的总分来定义的。结果：在调整潜在混杂因素后，与没有OSA或客观EDS的受试者相比，OSA合并客观EDS的全因死亡率高约2.5倍（风险比[HR]=2.451, 95%可信区间[95% ci]=1.319-4.556）， CVD死亡率高约3.9倍（HR=3.876, 95% ci =1.293-11.622）。此外，基线时有OSA、客观EDS和CVD的受试者的全因死亡率比基线时无OSA、客观EDS或CVD的受试者高2.9倍（HR=2.872, 95% CI=1.186-6.953）。相比之下，OSA合并主观EDS与全因风险或CVD死亡率增加无关。结论：目的EDS可能是OSA生物学严重程度的重要标志。未来的研究需要在不同的人群和干预性研究中验证这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep Medicine-Neurology (clinical)

CiteScore

8.70

自引率

10.70%

发文量

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