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IF 3.2 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Health and Quality of Life Outcomes Pub Date : 2025-03-24 DOI:10.1186/s12955-025-02355-1

Helene A Emsellem, Hilary H Colwell, John Cronin, Ronald H Farkas, Susan D Mathias

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引用次数: 0

摘要

背景：我们试图找出有关阻塞性睡眠呼吸暂停（OSA）症状和影响的重要问题，探讨疲劳和嗜睡问题，并评估特定患者报告结果（PRO）测量的内容、清晰度和相关性：研究对象为美国患有 OSA 且至少有轻度疲劳的患者。对不耐受正气压疗法或目前拒绝正气压疗法的人（非正气压疗法使用者）和在过去 12 个月内开始使用正气压疗法的人（正气压疗法使用者）进行了识别和访谈。访谈内容包括有关 OSA 症状和影响的概念激发问题。参与者随后完成了几项PRO测量（PRO测量信息系统[PROMIS] Fatigue-8a、PROMIS Sleep-Related Impairment-8a、埃普沃斯嗜睡量表[ESS]、患者对疲劳严重程度的总体印象[PGI-S Fatigue]和患者对疲劳变化的总体印象[PGI-C Fatigue]），并接受了认知汇报，以评估其内容、清晰度和相关性：共有 30 名 OSA 患者（20 名非 PAP 患者和 10 名 PAP 患者）参加了研究。除疲劳（100%）外，嗜睡（75%）、注意力难以集中（85%）、口干/咽干（60%）、头痛（50%）和睡眠中断（50%）是非 PAP 使用者报告的最常见症状。58% 的非 PAP 使用者认为疲劳是最令人烦恼的症状；5% 认为嗜睡是最令人烦恼的症状。在呼吸机使用者中，除疲劳（100%）外，最常见的症状（使用呼吸机前）是嗜睡（90%）、注意力难以集中（60%）、口干/咽干（60%）、头痛（50%）和睡眠中断（50%）。56% 的 PAP 使用者认为疲劳最令人烦恼；22% 的 PAP 使用者认为困倦最令人烦恼。所有参与者都分别提到了疲劳和嗜睡，这表明它们被认为是不同的症状。总的来说，参与者认为PRO测量结果是相关和清晰的，结果支持其内容效度、清晰度和相关性：疲劳是非 PAP 用户和 PAP 用户报告的最令人烦恼的症状。参与者将疲劳描述为与白天过度嗜睡截然不同的概念。参与者表示，他们的 OSA 症状对日常活动、功能、工作和人际关系产生了负面影响。PRO测量结果清晰明了，与OSA患者息息相关，适合在临床和研究环境中使用。

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Fatigue is distinct from sleepiness and negatively impacts individuals living with obstructive sleep apnea (OSA): results from qualitative research of individuals with OSA.

Background: We sought to identify important issues regarding symptoms and impacts of obstructive sleep apnea (OSA), to explore fatigue and sleepiness, and evaluate the content, clarity, and relevance of specific patient reported outcome (PRO) measures.

Methods: Participants in the US with OSA and at least mild fatigue were studied. Individuals with positive airway pressure (PAP) therapy intolerance or current PAP refusal (non-PAP users) and those who initiated PAP within the past 12 months (PAP users) were identified and interviewed. Interviews included concept elicitation questions about symptoms and impacts of OSA. Participants then completed several PRO measures (the PRO Measurement Information System [PROMIS] Fatigue-8a, PROMIS Sleep-Related Impairment-8a, Epworth Sleepiness Scale [ESS], Patient-Global Impression of Severity of Fatigue [PGI-S Fatigue], and Patient Global Impression of Change in Fatigue [PGI-C Fatigue]) and were cognitively debriefed to evaluate their content, clarity, and relevance.

Results: A total of 30 individuals with OSA (20 non-PAP and 10 PAP) were enrolled. In addition to fatigue (reported by 100%), sleepiness (75%), difficulty concentrating (85%), dry mouth/throat (60%), headaches (50%) and interrupted sleep (50%) were the most common symptoms reported by non-PAP users. Fifty-eight percent of non-PAP users rated fatigue as the most bothersome symptom; 5% rated sleepiness as the most bothersome. Among PAP users, the most common symptoms (prior to PAP use) in addition to fatigue (100%) were sleepiness (90%), difficulty concentrating (60%), dry mouth/throat (60%), headaches (50%), and interrupted sleep (50%). Fatigue was rated as most bothersome by 56% of PAP users; sleepiness was rated as the most bothersome by 22%. All participants mentioned fatigue and sleepiness separately, indicating they are considered distinct symptoms. In general, participants found the PRO measures to be relevant and clear, and results supported their content validity, clarity, and relevance.

Conclusions: Fatigue was the most bothersome symptom reported by non-PAP and PAP users. Participants described fatigue as a distinct and different concept from excessive daytime sleepiness. Participants reported that their OSA symptoms negatively impact daily activities, functioning, work, and relationships. The PRO measures are clear and relevant for individuals with OSA and appropriate for use in both clinical and research settings.

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来源期刊

Health and Quality of Life Outcomes 医学-卫生保健

CiteScore

7.30

自引率

2.80%

发文量

154

审稿时长

3-8 weeks

期刊介绍： Health and Quality of Life Outcomes is an open access, peer-reviewed, journal offering high quality articles, rapid publication and wide diffusion in the public domain. Health and Quality of Life Outcomes considers original manuscripts on the Health-Related Quality of Life (HRQOL) assessment for evaluation of medical and psychosocial interventions. It also considers approaches and studies on psychometric properties of HRQOL and patient reported outcome measures, including cultural validation of instruments if they provide information about the impact of interventions. The journal publishes study protocols and reviews summarising the present state of knowledge concerning a particular aspect of HRQOL and patient reported outcome measures. Reviews should generally follow systematic review methodology. Comments on articles and letters to the editor are welcome.