The Comorbidity Of Obstructive Sleep Apnea And Insomnia

Obstructive sleep apnea-hypopnea syndrome(OSAHS) is a common disease characterized by repetitive episodes of complete and partial obstructions of the upper airway that occur during sleep as a consequence of sleep apnea and hypoventilation.It is refers to nose and mouth air disappearing, while chest breathing still exist.Untreated sleep apnea often causes multiple organs damage or seriously endanger people’s health.The main signs of insomnia are difficulty in initiating sleep,difficulty in maintaining sleep,sleep quality decline,waking up too early, duration of total sleep time.Insomnia is a common condition,which impair job performance and quality of life.However insomnia usually appears in the presence of at least one other disorder.Their causal connection is inexplicable, which collectively called comorbid insomnia.Objective:To explore the correlation between OSAHS and insomnia. The primary aim of this study was to further explore the prevalence of insomnia complaints in OSAHS.To determine what is independent risk factor for insomnia among untreated sleep apnea patients. Future research examining the impact of insomnia on quality of life among untreated sleep apnea patients.Methods:We assigned 123 consecutive inpatients and outpatients who underwent polysomnography for clinically diagnosed OSAHS from the Second Affiliated Hospital of Nanchang University between May in 2013 and December in 2014. These participants were classified as the experimental group.We recorded their age, sex,BMI, comorbid diseases,and so on.The controls were 52 individuals age-matched sampled randomly from the outpatient and inpatient department, who eliminated OSAHS patients.Insomnia was defined using clinical guideline for the diagnosis and treatment of chronic insomnia in adults of Chinese among the experimental group.All the subjects accepted ESS scale,PSQI scale、DASS-21 scale、SF-12 scale.Then examine whether the coexistence of OSAHS and insomnia has differences on quality of life compared to OSAHS alone.Results:1. The majority of the OSAHS patients(56.91%) reported insomnia compared to30.77% of the controls(P < 0.05).Difficulties initiating sleep(DIS) was reported among 23.58% of OSAHS patients compared to 13.46% of controls,however,not significant between the two groups(P>0.05).Difficulties Maintaining Sleep(DMS)was reported among 43.09% of OSAHS patients compared to 19.23% of controls(P<0.05).2.Patients in the OSAHS-insomnia group were more likely to have hypertension and cerebral infarction than OSAHS alone(P<0.05).Among the OSAHS patients,female gender and elderly were independent risk factors for insomnia(P<0.05).In our study, there was no relationship between OSAHS severity expressed as AHI and insomnia.OSAHS patients with DIS reported a higher prevalence of hypertension and cerebral infarction compared to OSAHS patients without DIS(P<0.05).Among the OSAHS patients, female gender and elderly were independent risk factors for DIS( P<0.05).The OSAHS patients with DMS were higher prevalence of hypertension and cerebral infarction than the OSAHS patients without DMS(P<0.05).Among the OSAHS patients, those who with DMS were older.3.At last,we suggested that patients in the OSAHS-insomnia group reported significantly higher scored on PSQI scale and DASS-21 scale than those in the OSAHS-only group.And we found that patients in the OSAHS-insomnia group reported significantly lower scored on SF-12 PS scale and SF-12 MS scale than those in the OSAHS-only group.Conclusion:Overall these findings suggested that insomnia is a common complaint in patients being evaluated for OSAHS.Among the OSAHS patients, female gender,age,hypertension and cerebral infarction were independent risk factors for insomnia.We found that patients with both conditions may experience poorer quality of life compared to OSAHS alone.