The Analysis Of The Influencing Factors On Excessive Daytime Sleepiness In OSAHS Patients

OBJECTIVE:To analyze the influencing factors on excessive daytime sleepiness?EDS?in OSAHS patients.METHODS:The research includes 808 OSAHS patients who were diagnosed by PSG in Tianjin Medical University General Hospital from March 2016 to November2018.The patients are divided into 2 groups according to the standard of sleepiness.The patients whose ESS>9 are divided into the EDS group.There are 389 patients in the EDS group and 419 patients in the Non-EDS group.All the patients had done the questionnaire which contains the demographic data?age,gender,BMI,neck and waist circumference?,medical history and clinical symptoms?including ESS and clinical symptoms such as nocturnal apnea,awakening during sleep,paroxysmal sleep dyspnea,sleepwalking or dreaming,waking up in screaming or horror,nocturia,morning headache,fatigue,chronic cough,memory loss,heartburn,acid reflux,etc?.In the first partComparing the demographic data,the clinical symptoms and PSG parameters?mainly including sleep structure,respiratory events,nocturnal blood oxygenation,etc.?between the two groups,and the influencing factors of EDS are analyzed.466patients with severe OSAHS are matched with propensity scores.The same level of AHI in the EDS group and non-EDS group,comparing the demographic data and PSG parameters?including sleep structure,respiratory events and hypoxia?between the two groups and analyzing the main influencing factors of EDS in severe OSAHS at the same AHI level.RESULTS:1.Comparing EDS group with Non-EDS group in OSAHS patients:?1?In demographic data,the proportion of male patients in the EDS group was higher,and the neck,waist circumference and BMI are higher than the Non-EDS.The incidence of EDS in severe OSAHS patients?59.0%?was significantly higher than mild?29.8%?and moderate?36.5%?patients.?2?The incidence of clinical symptoms in the EDS group is higher than the Non-EDS.?3?AHI,MAI and ODI of the EDS group are higher;In the sleep structure,N1%and N1+N2%increased significantly,and N3%decreased;in the respiratory events,AI,HI,REM AHI,and NREM AHI of the EDS group are higher than those in the non-EDS group.The longest,average apnea time and the longest and average respiratory hypopnea time in the EDS group are longer than those in the non-EDS group.The total number of apneas,the total number of respiratory hypopneas in the EDS group are more than that of the non-EDS group.In EDS group,the average of SpO₂ and LSpO₂ are lower and T90%is higher.?4?Correlation analysis shows hypoxia?including T90%,ODI,average SpO₂ and LSpO₂?,OSAHS severity?AHI,especially NREM AHI?,respiratory events of apnea?including AI,total number of apneas?are related to ESS;while,AHI and T90%entered thebinary logistic regression,which had a positive effect on EDS.2.Comparing EDS group with the non-EDS group when the severe OSAHS patients are at same level of AHI:?1?Only average apnea time,average hypopnea time,average SpO₂ and T90%have differences statistically;nocturnal hypoxia?T90%?is the influencing factor in severe OSAHS patients.CONCLUSIONS:1.OSAHS patients with EDS are often associated with increased risk of obesity,increased sleep structural disturbances,increased sleep events,and increased hypoxia.ESS is primarily associated with hypoxia,severity of OSAHS and severity of apnea events.2.AHI and T90%are the main influencing factors of EDS in OSAHS patients.The important influencing factors of EDS in severe OSAHS patients with may be hypoxia.