Traditional Chinese Medicine Clinical Evaluation Studies Of Sleepiness State In Patients With OSAHS

1ObjectiveThis project was proposed by my supervisor and the aim is to find a way to evaluate daytime sleepiness from clinical viewpoint of Traditional Chinese Medicine (TCM). Finally, we will develop a scale about daytime sleepiness in adults with obstructive sleep apnea-hypopnea syndrome (OSAHS). And adult patients with OSAHS were included as subjects, with the purpose to find the correlation between the Chinese medicine syndrome scale and modern medicine scales, for example, Epworth sleepiness scale, and to test the reliability and validity. In addition, the scale is expected to be used as a tool to help diagnosis, severity degree, syndromes differentiation and to give a guide to the TCM treatment.2Methods2.1Philological methodsThe literature about daytime sleepiness symptoms, pathology, diagnostic methods, syndromes differentiation and treatment regularity were searched from Chinese medicine. Find out the methods to evaluate daytime sleepiness of OSAHS in modern medicine. Based on literature in Chinese medicine and the clinical experiences of doctors, Prof.Liu Yan-jiao and Prof.Sun Shu-chen, we developed a scale to assess the daytime sleepiness in OSAHS patients.2.2Clinical methodsThe preliminary scale was used to test patients randomly with OSAHS in sleep medical center and ENT department of Guang’anmen Hospital, China Academy of Chinese Medical Science. Also, other methods were adapted to get more information. For example, daytime sleepiness Scales:Epworth Sleepiness Score, the Stanford Sleepiness Scale (SSS); physical method:whole night polysomnography(PSG) examination(There are three sets of PSG recording equipment in the sleep monitoring room of Guang’anmen Hospital. They were developed by Sino-US Joint Cosmos,model SW-SM2000C).The daytime sleepiness situation were examined from subjective and objective perspectives. Based on these data, syndromes differentiation was made and treatment methods were enacted according to its result.2.3Sleep Medicine methodsBy the literature and theoretical studies, in addition to a variety of scales, analysis studies were made through the application of various detection and treatment methods of modern medicine, such as sleep questionnaires, PSG, etc.This article is mainly about the evaluation on daytime sleepiness of OSAHS patients by Chinese medical sleepiness scale. And the correlation between data from PSG and sleepiness scales was made to analyze the reliability and validity.2.4The application of methodsAll the materials were from patients in sleep medical center and ENT department, from September,2011to February,2012. The Survey was made among145patients randomly according to their clinical number. Every patient was interviewed and recorded carefully by author with selected scales. There are102patients completed all the scales. The scoring of PSG data, data input were done by author. The evaluation tools included:Chinese medicine sleepiness scale, Epworth Sleepiness Score, the Stanford Sleepiness Scale (SSS),PSG monitor. All the data were analyzed by SPSS17.0. Correlation analysis was done between score of sleep scales and PSG data to evaluate the reliability and validity of Chinese medical scale. And conclusion was made into the common syndrome differentiation of adult OSAHS patients.3ResultsThe correlation coefficient between the score of Chinese medicine sleepiness scale and AHI demonstrated by PSG data:r=0.925(P<0.05) of102patients.The result suggests a strong positive correlation between them; the correlation coefficient between the score of Chinese medicine sleepiness scale and minimum SaO2(%) demonstrated by PSG data:r=-0.700(P<0.05), which suggests a negative correlati5on between them; The correlation coefficient between the score of Chinese medicine sleepiness scale and Epworth sleepiness scale:r=0.768(P<0.05), which implies positive correlation between them. Parallel validity analysis proves that Chinese medicine sleepiness scale has a good parallel validity. The correlation coefficient between score of Chinese medicine sleepiness scale and SSS:r=0.394(P<0.05), which demonstrated a now so obvious positive correlation.4ConclusionsScore of Chinese medicine sleepiness scale has positive correlation with score of ESS and SSS. The result proves its validity and reliability which entail its ability to evaluate sleepiness degree of patients with OSAHS.Chinese medicine sleepiness scale is also useful to evaluate other symptoms and manifestations of OSAHS patients. By analyzing these manifestations, phlegm and blood stasis syndrome are the most common among OSAHS patients, especially the compound of them.