Volume 32, Issue 1 (Avicenna Journal of Clinical Medicine-Spring 2025)
Avicenna J Clin Med 2025, 32(1): 56-63 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rashidi F, Khazaei S, Kahramfar Z. Investigating the Possibility of Obstructive Apnea and Sleepiness in Patients with Chronic Obstructive Pulmonary Disease Based on Epworth Sleepiness Scale and STOP-BANG Questionnaires. Avicenna J Clin Med 2025; 32 (1) :56-63
URL: http://sjh.umsha.ac.ir/article-1-3202-en.html
URL: http://sjh.umsha.ac.ir/article-1-3202-en.html
1- General Practitioner, Hamadan University of Medical Sciences, Hamadan, Iran
2- Research Center for Health Sciences, Institute of Health Sciences and Technology, Avicenna Health Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran
3- Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran ,kahram_z@yahoo.com
2- Research Center for Health Sciences, Institute of Health Sciences and Technology, Avicenna Health Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran
3- Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran ,
Abstract: (98 Views)
Background and Objective: Chronic obstructive respiratory diseases are among the most common lung problems, especially among the elderly. These diseases can cause serious problems, such as obstructive sleep apnea and sleep. The present study aimed to assess the level of sleepiness and the possibility of obstructive apnea in patients with (COPD.
Materials and Methods: In this cross-sectional study, 121 patients diagnosed with COPD in Shahid Beheshti Hospital, Hamadan, were selected using available and consecutive sampling. Patients' sleepiness and obstructive sleep apnea frequency were compared using the Epworth Sleepiness Scale (ESS) and STOP-BANG questionnaire, respectively. Data were analyzed in SPSS software.
Results: The mean scores of the patient's age, body mass index (BMI), and duration of COPD were 67.02±10.57 years, 31.02±4.67 kg/m2, and 6.53±5.41 years. Regarding gender, 84 (69.4%) cases were male, and 37 (30.6%) subjects were female. The frequency of daily sleepiness was 24.9%, and the probability of having obstructive sleep apnea was 75.2%. A positive and significant correlation was detected between daily sleepiness score and obstructive sleep apnea (r=0.202; P=0.026). Moreover, the frequency of sleepiness was correlated with female gender (P<0.001), smoking at the time of the interview (P=0.025), old age (P=0.002), and higher BMI (P=0.049). Furthermore, obstructive sleep apnea was significantly correlated with male gender (P=0.002) and smoking in the past (P=0.002).
Conclusion: Obstructive sleep apnea has a direct effect on daytime sleepiness, and both variables are significantly affected by age, gender, BMI, as well as current and past smoking.
Materials and Methods: In this cross-sectional study, 121 patients diagnosed with COPD in Shahid Beheshti Hospital, Hamadan, were selected using available and consecutive sampling. Patients' sleepiness and obstructive sleep apnea frequency were compared using the Epworth Sleepiness Scale (ESS) and STOP-BANG questionnaire, respectively. Data were analyzed in SPSS software.
Results: The mean scores of the patient's age, body mass index (BMI), and duration of COPD were 67.02±10.57 years, 31.02±4.67 kg/m2, and 6.53±5.41 years. Regarding gender, 84 (69.4%) cases were male, and 37 (30.6%) subjects were female. The frequency of daily sleepiness was 24.9%, and the probability of having obstructive sleep apnea was 75.2%. A positive and significant correlation was detected between daily sleepiness score and obstructive sleep apnea (r=0.202; P=0.026). Moreover, the frequency of sleepiness was correlated with female gender (P<0.001), smoking at the time of the interview (P=0.025), old age (P=0.002), and higher BMI (P=0.049). Furthermore, obstructive sleep apnea was significantly correlated with male gender (P=0.002) and smoking in the past (P=0.002).
Conclusion: Obstructive sleep apnea has a direct effect on daytime sleepiness, and both variables are significantly affected by age, gender, BMI, as well as current and past smoking.
Type of Study: Original |
Subject:
Lung Diseases
References
1. Roche N, Laurendeau C, Raherison C, Fuhrman C, Burgel PR. Modeling future COPD epidemiology. Eur Respiratory Soc; 2016. Link
2. Sharifi H, Ghanei M, Jamaati H, Masjedi MR, Aarabi M, Sharifpour A, et al. Burden of obstructive lung disease study in Iran: First report of the prevalence and risk factors of COPD in five provinces. Lung India. 2019;36(1):14-19. PMID: 30604700 DOI: 10.4103/lungindia.lungindia_129_18
3. Saddki N, Mohamad H, Yusof NIM, Mohamad D, Mokhtar N, Bakar WZW. Validity and reliability of the Malay version of sleep apnea quality of life index–preliminary results. Health Qual Life Outcomes. 2013;11(1):100. PMID: 23786866 DOI: 10.1186/1477-7525-11-100
4. Sin DD, Fitzgerald F, Parker JD, Newton G, Floras JS, Bradley TD. Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure. Am J Respir Crit Care Med. 1999;160(4):1101-1106. PMID: 10508793 DOI: 10.1164/ajrccm.160.4.9903020
5. Schröder CM, O'Hara R. Depression and obstructive sleep apnea (OSA). Ann Gen Psychiatry. 2005;4(1):13. PMID: 15982424 DOI: 10.1186/1744-859X-4-13
6. Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med. 2015;3(4):310-318. PMID: 25682233 DOI: 10.1016/S2213-2600(15)00043-0
7. Falsafi T, Valizadeh N, Sepehr S, Najafi M. Application of a stool antigen test to evaluate the incidence of Helicobacter pylori infection in children and adolescents from Tehran, Iran. Clin Diagn Lab Immunol. 2005;12(9):1094-1097. PMID: 16148176 DOI: 10.1128/CDLI.12.9.1094-1097.2005
8. Roger VL. Epidemiology of heart failure. Circ Res. 2013; 113(6): 646-659. PMID: 23989710 DOI: 10.1161/CIRCRESAHA.113.300268
9. Owens RL, Malhotra A. Sleep-disordered breathing and COPD: the overlap syndrome. Respir Care. 2010;55(10):1333-1346. PMID: 20875160
10. Guilleminault C, Cummiskey J, Motta J. Chronic obstructive airflow disease and sleep studies. Am Rev Respir Dis. 1980;122(3):397-406. PMID: 7416615 DOI: 10.1164/arrd.1980.122.3.397
11. Krachman SL, Chatila W, Martin UJ, Nugent T, Crocetti J, Gaughan J, et al. Effects of lung volume reduction surgery on sleep quality and nocturnal gas exchange in patients with severe emphysema. Chest. 2005; 128 (5):3221-3218. PMID: 16304265 DOI: 10.1378/chest.128.5.3221
12. Hidalgo MPL, De Souza CM, Zanette CB, Nunes PV. Association of daytime sleepiness and the morningness/eveningness dimension in young adult subjects in Brazil. Psychol Rep. 2003;93(2):427-434. PMID: 14650667 DOI: 10.2466/pr0.2003.93.2.427
13. Dehghani M, Sadeghniat K, Ebrahimi M. Relationship between Epworth sleepiness scale and obstructive sleep apnea with road accidents. Iran Occup Health. 2015;12(1):87-96. Link
14. Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, Islam S, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008;108(5):812-821. PMID: 18431116 DOI: 10.1097/ALN.0b013e31816d83e4
15. Vanfleteren LEGW, Beghe B, Andersson A, Hansson D, Fabbri LM, Grote L. Multimorbidity in COPD, does sleep matter? Eu JIntern Med. 2020; 73:7-15. PMID: 31980328 DOI: 10.1016/j.ejim.2019.12.032
16. Enz C, Brighenti-Zogg S, Steveling-Klein EH, Dürr S, Maier S, Miedinger D, et al. Predictors of increased daytime sleepiness in patients with chronic obstructive pulmonary disease: a cross-sectional study. Sleep Disord. 2016;2016:1089196. PMID: 27822390 DOI: 10.1155/2016/1089196
17. Bonsignore M, Sacco T, Braghiroli A, Fanfulla F, Ferini-Strambi L, Bue AL, et al. Residual excessive daytime sleepiness (EDS) in Italian patients with obstructive sleep apnea (OSA) treated with continuous positive airway pressure (CPAP): preliminary results of the OSAREDS study. Eur Respiratory Soc. 2022; 60(suppl66):636. DOI:10.1183/13993003.congress-2022.636
18. Kara O, Elibol T, Koc Okudur S, Smith L, Soysal P. Associations between anemia and insomnia or excessive daytime sleepiness in older adults. Acta Clin Belgica. 2023;78(3):223-228. PMID: 36036443 DOI: 10.1080/17843286.2022.2116895
19. Afroz DN, Patalano F, Naujoks C, Gutzwiller F. Prs60 impact of sleep disturbance on health-related quality of life in chronic obstructive pulmonary disease (COPD): what do we know so far? Value Health. 2019; 22:S883. DOI: 10.1016/j.jval.2019.09.2549
20. Ameli J, Ghanei M, Karami GH, Saadat A. Polysomnography of 31 mustard gas exposed veterans with complaint of respiratory sleep problem in Baqiyatallah (as) hospital. J Mil Med. 2007;9(1):7-14. Link
21. Soler X, Liao S-Y, Marin JM, Lorenzi-Filho G, Jen R, DeYoung P, et al. Age, gender, neck circumference, and Epworth sleepiness scale do not predict obstructive sleep apnea (OSA) in moderate to severe chronic obstructive pulmonary disease (COPD): The challenge to predict OSA in advanced COPD. PLoS One. 2017;12(5):e0177289. PMID: 28510598 DOI: 10.1371/journal.pone.0177289
22. Bastani F, Farajtabar F. Assessment of insomnia severity in ederly patients with chronic obstructive pulmonary disease in Rasoul Akram hospital, 2019 Tehran. J Ardabil Univ Med Sci. 2020; 20(1):20-31. DOI: 10.29252/jarums.20.1.20
23. Eslaminejad A, Safa M, Ghassem Boroujerdi F, Hajizadeh F, Pashm Foroush M. Relationship between sleep quality and mental health according to demographics of 850 patients with chronic obstructive pulmonary disease. J Health Psychol. 2017;22(12):1603-1613. PMID: 28770626 DOI: 10.1177/1359105316684937
24. Maričić L, Višević R, Včeva A, Včev A, Labor S. Risk assessment for sleep apnea syndrome and excessive daytime sleepiness in patients with chronic obstructive pulmonary disease. Acta Med Croatica. 2013;67(3):219-224. PMID: 25007431
25. Zohal MA, Yazdi Z, Kazemifar AM. Daytime sleepiness and quality of sleep in patients with COPD compared to control group. Glob J Health Sci. 2013;5(3):150-155. PMID: 23618484 DOI: 10.5539/gjhs.v5n3p150
26. Faria AC, da Costa CH, Rufino R. Sleep apnea clinical score, Berlin questionnaire, or Epworth sleepiness scale: which is the best obstructive sleep apnea predictor in patients with COPD? Int J Gen Med. 2015;8:275-281. PMID: 26345497 DOI: 10.2147/IJGM.S86479
27. Sachdeva S. Assessment of sleep and quality of life among chronic obstructive airways disease patients, New Delhi, India. J Assoc Chest Physicians. 2018;6:45-52. Link
28. Farajzadeh M, Hosseini M, Mohtashami J, Fathi M, Karimi B, Yousefi B. Obstructive sleep apnea in elderly and its related factors. Iran J Nurs.2016; 29(99):1-9. DOI:10.29252/ijn.29.99.100.1
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Articles Copyright © The Author(s).
Owned by Hamadan University of Medical Sciences
Published by UMSHA Press
Journal Tel: +988138380924
Publisher Tel:+988138380548
Website: http://sjh.umsha.ac.ir
Email: s_ journal[at]umsha.ac.ir
