Nasal CPAP improves the quality of life and lessens the depressive symptoms in patients with obstructive sleep apnea syndrome
Nasal CPAP improves the quality of life and lessens the depressive symptoms in patients with obstructive sleep apnea syndrome
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DOI：
10.2169/internalmedicine.44.422
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发表时间：
2005-05-01
影响因子：
1.2
通讯作者：
Horie, T
中科院分区：
文献类型：
--
作者：
Kawahara, S;Akashiba, T;Horie, T
目的探讨阻塞性睡眠呼吸暂停综合征（OSAS）患者鼻腔持续气道正压通气（CPAP）对过度嗜睡（EDS）、抑郁状态和生活质量的影响。对132例阻塞性睡眠呼吸暂停综合征（OSAS）患者和对照组采用Epworth嗜睡量表（ESS）评估EDS， Zung自我抑郁量表（SDS）评估情绪，SF-36量表评估生活质量。患者有严重的OSAS（呼吸暂停-低通气指数，59.4 +/- 23.8/h），嗜睡和抑郁更严重，生活质量比38名年龄和性别匹配的对照组差。结果治疗前，SF-36的大部分生活质量域与患者SDS评分显著相关。使用鼻腔CPAP时，ESS和SDS评分分别从9.7 +/- 4.5降至4.0 +/- 2.4 (p < 0.0001)，从49.2 +/- 10.4降至45.1 +/- 9.6 （p < 0.0005）。SF-36总评分和8个领域中的7个得分随治疗显著增加。因此，鼻腔CPAP可减轻严重OSAS患者的EDS和抑郁，并改善生活质量。此外，SF-36总分的变化幅度和8个域中的5个域的变化幅度与经鼻CPAP治疗后SDS评分的变化幅度显著相关。SF-36域的治疗相关评分变化与ESS评分变化之间无明显关系。结论重度OSAS患者的生活质量较对照组差，但经鼻CPAP可通过减轻抑郁而改善生活质量。
Objective To assess changes in response to nasal continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea syndrome (OSAS) concerning excessive daytime sleepiness (EDS), depressive state, and quality of life (QOL).Patients and Methods We assessed for EDS using the Epworth sleepiness scale (ESS), for mood using The Zung self-depression scale (SDS), and for QOL using Short-Form 36 (SF-36) in 132 patients with obstructive sleep apnea syndrome (OSAS) and control subjects. Patients had severe OSAS (apnea-hypopnea index, 59.4 +/- 23.8/h) and were more hypersomnolent and depressed, and had poorer QOL than 38 age- and gender-matched controls.Results Before treatment most QOL domains in the SF-36 were significantly associated with patients' SDS scores. With nasal CPAP, ESS and SDS scores were respectively decreased from 9.7 +/- 4.5 to 4.0 +/- 2.4 (p < 0.0001) and from 49.2 +/- 10.4 to 45.1 +/- 9.6 (p < 0.0005). Total SF-36 score and scores for seven of eight domains were increased significantly with treatment. Thus, nasal CPAP lessens EDS and depression, and improves QOL, in patients with severe OSAS. Further, magnitudes of changes in total SF-36 scores and in five of eight domains correlated significantly with magnitude of change in SDS score upon nasal CPAP treatment. No relationship was evident between treatment-associated score changes in SF-36 domains and ESS score change.Conclusion Although patients with severe OSAS have poorer QOL than control subjects, nasal CPAP appears to improve QOL by alleviating depression.