Polysomnographic characteristics of daytime sleepiness in obstructive sleep apnea syndrome

Abstract

The results suggest that EDS in OSAS patients are characterized by the following aspects of nocturnal sleep: (1) severe sleep apnea/hypopnea and hypoxemia, (2) fragmented sleep, (3) low quality of sleep, and (4) high pressure of sleep drive.

The relationship between the Epworth Sleepiness Scale and polysomnographic parameters in obstructive sleep apnea patients

“…BMI was also one of the three major determinants of the ESS score [6]. Our study showed that BMI was also significantly greater in the EDS patients than in the no-EDS patients, suggesting that obesity may have an effect on the severity of OSA in accordance with previous studies [5,6,10,12,13], contrary to other studies [11].…”

“…Moreover, nocturnal oxygenation indices were significantly worse [higher ODI, lower minimum SpO 2 and longer time (SpO 2 \ 90%)] in the EDS patients compared to the patients without EDS. Thus, our findings, like others [2,6,10,11], suggest that nocturnal hypoxemia may have a significant role in the pathogenesis of EDS in OSA patients with considerable consistency. Although the exact biological mechanisms are unknown, it was postulated that increased hypoxemia causes severe neural damage of wake-promoting structures, leading to EDS [15].…”

“…First of all, EDS patients had more severe apnea/hypopnea and hypoxemia than no EDS patients. Most authors were able to show some relationship between AHI and ESS [5,6,[10][11][12]. The ESS score progressively increased as the severity of OSA aggravated [6,13,14].…”

“…The ESS score progressively increased as the severity of OSA aggravated [6,13,14]. Compared to no EDS patients, EDS patients exhibited a greater AHI [1,[10][11][12], though not wholly agreed [2]. Recent study showed no correlation between the ESS and the AHI, ODI, and minimum SpO 2 in patients with upper airway pathology [7].…”

“…And in our opinion, if studied under exquisite condition, a meaningful correlation of ESS with AHI and ODI may be identified. The next important factor is nocturnal hypoxemia, which has been considered in a majority of literature to be a major determinant of EDS in OSA patients [2,6,10,11]. Although denied in a few studies [1,7], progressive worsening of nocturnal hypoxemia was observed from mild to severe OSA patients with a strong correlation with ESS score [6].…”