Abstract

Objective: Excessive daytime sleepiness (EDS) is a common symptom in patients with obstructive sleep apnea (OSA), and the reason for this could not be fully elucidated. The aim of this study was to compare polysomnographic and demographic features of patients with OSA with or without EDS according to Epworth Sleepiness Scale (ESS). Material and Methods: A total of 82 adult patients who were diagnosed with OSA with polysomnography were retrospectively divided into 2 groups in terms of having EDS (ESS>10) or not (ESS≤10) according to ESS score. Results: Forty six patients had an ESS score >10. Patients with OSA suffering from sleepiness were younger (p=0.010), more obese (p=0.039), had higher arousal index (p=0.051) and apnea hypopnea index (AHI) (p=0.036) on polysomnography. There was no gender difference between two groups (p=0.423). Polysomnographic findings revealed that there were no differences in total sleep time, sleep efficiency or overall distribution of sleep stages (N1,N2, N3, REM), or nocturnal mean and minimum saturation (p=0.516, p=0.790, p=0.674, p=0.852, p=0.677, p=0.137, p=0.286, p=0.353, respectively). On multivariate regression analysis, arousal index, total AHI, and age were effective in determination of ESS score (p<0.001). Conclusion: OSA patients with EDS were younger and more obese when compared to OSA patients with no EDS. No single factor was effective for detection of EDS with ESS score. Rather, factors such as severity of OSA, arousal index, and age were collectively decisive.

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