Abstract
Purpose: The aim of this study was to explore the clinical characteristics of different sleep perception types of obstructive sleep apnea–hypopnea syndrome (OSAHS) patients and to analyze the correlation between sleep perception and polysomnography (PSG) indicators in OSAHS patients.Methods: We retrospectively analyzed 355 patients diagnosed with OSAHS by PSG at the Sleep Medicine Center of Shengjing Hospital of China Medical University. Patients saw a doctor due to snoring and daytime sleepiness from March 2017 to March 2018. We excluded the patients who are <18 years old, had a history of OSAHS treatment, had other sleep and psychiatric disorders, and could not provide complete data. According to the patients' explanation, medical history, PSG indicators, and morning questionnaire after PSG, the patients were divided into normal sleep perception (NSP), positive sleep perception abnormality (PSPA), and negative sleep perception abnormality (NSPA). We analyze the demographic characteristics and PSG of the three groups with ANOVA and non-parametric tests. In addition, we conducted correlation analysis between sleep perception and PSG indicators.Results: Of OSAHS patient, 55.5% had sleep perception abnormalities, of which 35.5% were positive-perception abnormalities and 20% were negative-perception abnormalities. From the analysis of PSG indicators, the sleep perception abnormality was related to the frequency of spontaneous arousal of the patient (P = 0.003) and was not related to the slight arousal caused by respiratory events, oxygen desaturations, and limb movement events. OSAHS patients with PSPA had a higher oxygen desaturation index (P = 0.046) but no significant difference in post hoc test. PSPA group had significantly lower rapid eye movement (REM) latency and sleep efficiency and more wake after sleep onset (WASO) than had the other sleep perception groups. Multivariate linear regression analyses after adjusting for age and sex revealed that sleep perception was related to lowest oxygen saturation (LSaO2), TS90%, sleep efficiency, and WASO.Conclusion: Sleep perception abnormality is common in OSAHS patients. OSAHS patients with different sleep perception types have different PSG profiles. The OSAHS patients with PSPA have more severe hypoxia levels at night that require timely personalized treatment.
Highlights
Obstructive sleep apnea–hypopnea syndrome (OSAHS) is a common sleep-related breathing disease
Abnormal sleep perception mainly refers to the discrepancy between subjective assessment and objective detection, which can be divided into positive discrepancy and negative discrepancy
TST, total sleep time; AHI, apnea–hypopnea index; ODI, oxygen desaturation index; LSaO2, lowest oxygen saturation; REM (%TST), the percentage of REM sleep to TST; N1 (%TST), N2 (%TST), and N3 (%TST), the percentage of N1 period, N2 period, and N3 period to TST; TS90%, the percentage of time when oxygen saturation is lower than 90% to TST; PLMI, periodic limb movement index; wake after sleep onset (WASO), weak after sleep onset; PSG, polysomnography; OSAHS, obstructive sleep apnea–hypopnea syndrome; NSPA, negative sleep perception abnormality; NSP, normal sleep perception; PSPA, positive sleep perception abnormality
Summary
Obstructive sleep apnea–hypopnea syndrome (OSAHS) is a common sleep-related breathing disease. From the patients’ medical history, we found that they slept all night, the patients still felt fatigued and sleepy during the daytime. This phenomenon prompts us to pay more attention to the sleep perception of the patients with OSAHS. Sleep perception refers to the self-assessment of an individual’s sleep state and mainly includes a subjective description of the quantity and quality of his or her sleep. This subjective evaluation has become one of the foundations for the diagnosis and evaluation of sleep disorders [2]. Research has provided relatively little insight into different sleep perception types in OSAHS patients, especially positive discrepancy
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