Relationships Between Health-related Quality Of Life And Mood, Sleepiness, Illness Severity In Patients With Obstructive Sleep Apnea-Hypopnea Syndrome

Objective To determine the predictors of the health-related quality of life (HRQoL) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), and to explore the relationships between severity of OSAHS, excessive daytime sleepiness (EDS), and mood, to better understand the relationship between objective sleep disturbance and subjective experience.Methods 108 Chinese patients with OSAHS were assessed for HRQoL using one disease-specific measure, the Calgary sleep apnea quality of life index (SAQLI), for EDS using the Epworth sleepiness scale (ESS), for mood using the Zung self-rating depression scale (SDS) and Zung self-rating anxiety scale (SAS). The associations between each domain and the total score on SAQLI and the polysomnographic parameters, ESS score, SDS score and SAS score, etc, were examined by Person linear correlation. Independent predictors of HRQOL was determined by stepwise multiple regression analysis.Results Significant correlation was observed between SDS/SASscore and ESS score, but no correlation between SDS/SAS score and the polysomnographic parameters. There was no relationship between SAQLI scores and the polysomnographic parameters. Four domains and the total score on SAQLI were significantly correlated with the SDS, SAS and ESS score. Stepwise multiple regression analysis selected two variables, the SAS score and ESS score as independent factors for predicting the total score and the most domains' scores on SAQLI. They accounted for 43.4% of the total variance in the total score on SAQLI (R2=0.434, P<0.001). SAS score is the strongest factor to predict all domains and the total score on SAQLI.Conclusions OSAHS severity by itself would not be a predictor of HRQoL. Mood such as anxiety, self-ratings of sleepiness will serve to be stronger predictors of HRQoL. Mood disturbance and sleepiness should have close effect on each other. Mood may be influenced by subjective experience of daytime sleepiness rather than by actual sleep disturbance.