부산대학교 도서관

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1365-2869.2008.00663.x Byline: IOANNIS KOUTSOURELAKIS, ELENI PERRAKI, ANASTASIOS BONAKIS, EMMANOUIL VAGIAKIS, CHARIS ROUSSOS, SPYROS ZAKYNTHINOS Keywords: depression; diabetes; Epworth Sleepiness Scale; excessive daytime sleepiness; obstructive sleep apnoea Abstract: Summary Although daytime sleepiness is commonly associated with obstructive sleep apnoea (OSA), the relationship between OSA severity and subjective sleepiness has been documented elusive. This study aimed to identify clinical and polysomnographic determinants of subjective sleepiness among patients suspected of having OSA. A sleep clinic-based sample of 915 patients was interviewed with a structured questionnaire and underwent diagnostic overnight polysomnography. Subjective sleepiness was quantified by Epworth Sleepiness Scale (ESS). Excessive daytime sleepiness (defined as ESS score > 10) was present in 38.8% of patients. In multiple linear regression analysis, respiratory disturbance index [RDI; used to define (whenever RDI was >5) and quantify OSA], depression and diabetes were the most important determinants of ESS score accounting for 17%, 11% and 6% of its variability respectively. Chronic obstructive pulmonary disease (COPD), stroke, heart disease, alcohol use and body mass index were less important determinants of ESS score explaining 1-3% of its variability. In conclusion, OSA should not be considered the sole potential cause of increased subjective sleepiness in patients suspected of having OSA. Primarily depression and diabetes, but also COPD, stroke, heart disease, alcohol use and increased body mass index may contribute to increased subjective sleepiness. Article History: Accepted in revised form 13 March 2008; received 29 November 2007 Article note: Spyros G. Zakynthinos, Department of Critical Care and Pulmonary Services, Medical School of Athens University, Evangelismos Hospital, 45-47 Ipsilandou Str, GR 106 75, Athens, Greece. Tel.: 0030 210 72 43 320; fax: 0030 210 72 16 503; e-mail: szakynthinos@yahoo.com