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Depressive symptoms and obesity as predictors of sleepiness and quality of life in patients with REM-related obstructive sleep apnea: cross-sectional analysis of a large clinical population.
Sleep Med. 2011 Oct; 12(9):827-31.SM

Abstract

BACKGROUND

The clinical significance of rapid eye-movement (REM)-related obstructive sleep apnea (OSA) is unknown. Moreover, it is unclear what the determinants of sleepiness and quality of life (QoL) are among these patients. Our aim was to identify whether the apnea-hypopnea index during REM sleep (AHI(REM)), AHI during NREM sleep (AHI(NREM)), depressive symptoms, or obesity are independent predictors of excessive daytime sleepiness and reduced QoL in patients with REM-related OSA. We also assessed if these characteristics were predictors of sleepiness and QoL in all patients with OSA (AHI ≥ 5) as well as in non-stage specific OSA.

METHODS

This was a cross-sectional analysis of a clinic-based population with OSA. In order to minimize the contribution of AHI(NREM), we defined REM-related OSA using the following criteria: an overall AHI ≥ 5, AHI(REM)/AHI(NREM) ≥ 2, AHI(NREM)<lowest quartile, and REM sleep in minutes > the lowest quartile of the entire cohort. We examined the predictors of subjective sleepiness using the Epworth Sleepiness Scale (ESS) and QoL using the short-form quality of life questionnaire-12 (SF-12).

RESULTS

Of 1019 consecutive adults that were referred for their first in-laboratory polysomnogram for suspicion of OSA over a 10 month period, 931 had OSA. REM-related OSA was present in 126 patients. In adjusted linear regression models, AHI(NREM) was a significant predictor of sleepiness in the entire cohort of patients with OSA as well as non-stage specific OSA, but not in the REM-related OSA group. AHI(REM) was not a significant predictor of ESS or QoL in any of the three groups. However, greater depressive symptoms and body mass index were significant independent predictors of ESS and reduced QoL in the REM-related OSA group.

CONCLUSION

Higher depression scores and obesity, rather than the severity of OSA (as measured by AHI(NREM) and AHI(REM)), were predictive of sleepiness and QoL scores in patients with REM-related OSA.

Authors+Show Affiliations

Sleep Disorders Center, Section of Pulmonary and Critical Care, Department of Medicine, University of Chicago, Chicago, IL 60637, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21978724

Citation

Pamidi, Sushmita, et al. "Depressive Symptoms and Obesity as Predictors of Sleepiness and Quality of Life in Patients With REM-related Obstructive Sleep Apnea: Cross-sectional Analysis of a Large Clinical Population." Sleep Medicine, vol. 12, no. 9, 2011, pp. 827-31.
Pamidi S, Knutson KL, Ghods F, et al. Depressive symptoms and obesity as predictors of sleepiness and quality of life in patients with REM-related obstructive sleep apnea: cross-sectional analysis of a large clinical population. Sleep Med. 2011;12(9):827-31.
Pamidi, S., Knutson, K. L., Ghods, F., & Mokhlesi, B. (2011). Depressive symptoms and obesity as predictors of sleepiness and quality of life in patients with REM-related obstructive sleep apnea: cross-sectional analysis of a large clinical population. Sleep Medicine, 12(9), 827-31. https://doi.org/10.1016/j.sleep.2011.08.003
Pamidi S, et al. Depressive Symptoms and Obesity as Predictors of Sleepiness and Quality of Life in Patients With REM-related Obstructive Sleep Apnea: Cross-sectional Analysis of a Large Clinical Population. Sleep Med. 2011;12(9):827-31. PubMed PMID: 21978724.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depressive symptoms and obesity as predictors of sleepiness and quality of life in patients with REM-related obstructive sleep apnea: cross-sectional analysis of a large clinical population. AU - Pamidi,Sushmita, AU - Knutson,Kristen L, AU - Ghods,Farbod, AU - Mokhlesi,Babak, Y1 - 2011/10/05/ PY - 2011/05/24/received PY - 2011/08/17/revised PY - 2011/08/18/accepted PY - 2011/10/8/entrez PY - 2011/10/8/pubmed PY - 2012/3/9/medline SP - 827 EP - 31 JF - Sleep medicine JO - Sleep Med VL - 12 IS - 9 N2 - BACKGROUND: The clinical significance of rapid eye-movement (REM)-related obstructive sleep apnea (OSA) is unknown. Moreover, it is unclear what the determinants of sleepiness and quality of life (QoL) are among these patients. Our aim was to identify whether the apnea-hypopnea index during REM sleep (AHI(REM)), AHI during NREM sleep (AHI(NREM)), depressive symptoms, or obesity are independent predictors of excessive daytime sleepiness and reduced QoL in patients with REM-related OSA. We also assessed if these characteristics were predictors of sleepiness and QoL in all patients with OSA (AHI ≥ 5) as well as in non-stage specific OSA. METHODS: This was a cross-sectional analysis of a clinic-based population with OSA. In order to minimize the contribution of AHI(NREM), we defined REM-related OSA using the following criteria: an overall AHI ≥ 5, AHI(REM)/AHI(NREM) ≥ 2, AHI(NREM)<lowest quartile, and REM sleep in minutes > the lowest quartile of the entire cohort. We examined the predictors of subjective sleepiness using the Epworth Sleepiness Scale (ESS) and QoL using the short-form quality of life questionnaire-12 (SF-12). RESULTS: Of 1019 consecutive adults that were referred for their first in-laboratory polysomnogram for suspicion of OSA over a 10 month period, 931 had OSA. REM-related OSA was present in 126 patients. In adjusted linear regression models, AHI(NREM) was a significant predictor of sleepiness in the entire cohort of patients with OSA as well as non-stage specific OSA, but not in the REM-related OSA group. AHI(REM) was not a significant predictor of ESS or QoL in any of the three groups. However, greater depressive symptoms and body mass index were significant independent predictors of ESS and reduced QoL in the REM-related OSA group. CONCLUSION: Higher depression scores and obesity, rather than the severity of OSA (as measured by AHI(NREM) and AHI(REM)), were predictive of sleepiness and QoL scores in patients with REM-related OSA. SN - 1878-5506 UR - https://www.unboundmedicine.com/medline/citation/21978724/Depressive_symptoms_and_obesity_as_predictors_of_sleepiness_and_quality_of_life_in_patients_with_REM_related_obstructive_sleep_apnea:_cross_sectional_analysis_of_a_large_clinical_population_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1389-9457(11)00257-7 DB - PRIME DP - Unbound Medicine ER -