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Polysomnographic characteristics of excessive daytime sleepiness phenotypes in obstructive sleep apnea: results from the international sleep apnea global interdisciplinary consortium
Dept Family Med, Primary Hlth Care Capital Area, Reykjavik, Iceland.;Univ Iceland, Fac Med, Dept Med, Reykjavik, Iceland.;Univ Iceland, Fac Med, IS-108 Reykjavik, Iceland.;Primary Hlth Care Capital Area, IS-108 Reykjavik, Iceland..
Univ Penn, Perelman Sch Med, Dept Med, Div Sleep Med, Philadelphia, PA USA..ORCID iD: 0000-0002-2879-0484
Univ Iceland, Fac Med, Dept Med, Reykjavik, Iceland.;Natl Univ Hosp Iceland, Sleep Dept, Landspitali, Reykjavik, Iceland..ORCID iD: 0000-0002-6773-9876
Corporal Michael J Crescenz VA Med Ctr, Dept Med, Philadelphia, PA USA..
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2024 (English)In: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 47, no 4Article in journal (Refereed) Published
Abstract [en]

Study Objectives: Excessive daytime sleepiness (EDS) is a major symptom of obstructive sleep apnea (OSA). Traditional polysomnographic (PSG) measures only partially explain EDS in OSA. This study analyzed traditional and novel PSG characteristics of two different measures of EDS among patients with OSA. Methods: Sleepiness was assessed using the Epworth Sleepiness Scale (>10 points defined as "risk of dozing") and a measure of general sleepiness (feeling sleepy >= 3 times/week defined as "feeling sleepy"). Four sleepiness phenotypes were identified: "non-sleepy," "risk of dozing only," "feeling sleepy only," and "both at risk of dozing and feeling sleepy." Results: Altogether, 2083 patients with OSA (69% male) with an apnea-hypopnea index (AHI) >= 5 events/hour were studied; 46% were "non-sleepy," 26% at "risk of dozing only," 7% were "feeling sleepy only," and 21% reported both. The two phenotypes at "risk of dozing" had higher AHI, more severe hypoxemia (as measured by oxygen desaturation index, minimum and average oxygen saturation [SpO(2)], time spent < 90% SpO(2), and hypoxic impacts) and they spent less time awake, had shorter sleep latency, and higher heart rate response to arousals than "non-sleepy" and "feeling sleepy only" phenotypes. While statistically significant, effect sizes were small. Sleep stages, frequency of arousals, wake after sleep onset and limb movement did not differ between sleepiness phenotypes after adjusting for confounders. Conclusions: In a large international group of patients with OSA, PSG characteristics were weakly associated with EDS. The physiological measures differed among individuals characterized as "risk of dozing" or "non-sleepy," while "feeling sleepy only" did not differ from "non-sleepy" individuals.

Place, publisher, year, edition, pages
Oxford University Press, 2024. Vol. 47, no 4
Keywords [en]
Excessive daytime sleepiness, obstructive sleep apnea, polysomnography
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:uu:diva-533292DOI: 10.1093/sleep/zsae035ISI: 001173695400001PubMedID: 38315511OAI: oai:DiVA.org:uu-533292DiVA, id: diva2:1879055
Available from: 2024-06-27 Created: 2024-06-27 Last updated: 2025-02-20Bibliographically approved

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Janson, Christer

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