Publication: Multipl Skleroz hastalarında uyku bozuklukları ve obstruktif uyku apne sendrom riskinin değerlendirilmesi
Abstract
ÖZETAmaç: Bu çalışmadaki amaç, Multipl Skleroz (MS) hastalarında obstrüktif uyku apne sendromu (OUAS)’u sıklığını STOP-BANG testi ile belirlemek ve yüksek riskli hastalarda tanıyı polisomnografi tetkiki ile doğrulamaktır. Ayrıca, OUAS riski ile yorgunluk, uykululuk, depresyon, özürlülük durumu ilişkisi incelenecektir. Gereç ve Yöntem: Marmara Üniversitesi Nöroloji polikliniğinde takipli 97 hasta (36 erkek, 61 kadın) çalışmaya dahil edildi. Tüm hastalara STOP-BANG anketi, Epworth Uykululuk Ölçeği (EUÖ), Beck Depresyon Envanteri (BDE), Pittsburgh Uyku Kalite indeksi (PUKİ), Genişletilmiş Özürlülük Durum Ölçeği (EDSS) uygulandı. OUAS’u için yüksek riskte bulunan hastalara PSG testi uygulandı.Bulgular: STOP-BANG anketine göre hastaların %24,7’si OUAS’u için yüksek riskli bulundu. PSG uyku tetkikine göre %11,3 hastada OUAS’u tanısı saptandı. MS hasta grubunda ileri yaş, OUAS’u için risk faktörü olarak saptanmıştır (p=0,010). EUÖ ile STOP-BANG testi arasında pozitif yönde bir ilişki saptanırken (p=0,001) PSG sonuçları ile bu ilişki saptanamadı. Sonuçlar: Sonuç olarak, çalışmamızda MS hastalarında OUAS prevalansı kullanılan yöntemler dikkate alındığında literatür ile uyumlu olarak saptanmıştır. Genel popülasyonda OUAS’u için bir risk faktörü olan ileri yaş, MS hastalarında hem STOP-BANG testi hem de PSG tetkiki kullanılarak OUAS tanısı koyulduğunda, risk faktörü olarak saptanmıştır. STOP-BANG testi, her ne kadar genel popülasyon için geçerli ve güvenilir bir test olsa da PSG tetkikinin, OUAS tanısında altın standart olduğu göz önüne alındığında özellikle yorgunluk sıklığının çok yüksek olduğu MS hastalarında OUAS tanı ve taraması için STOP-BANG testi yanıltıcı olabilir.
ABSTRACTAim: The aim of this study is to determine the possible risk of OSAS in patients with MS using the STOP-BANG questionnaire, and to confirm the pre-diagnosis of OSAS by recording polysomnographic investigation in individuals with high risk. In addition, the relationship between OSAS risk and fatigue, sleepiness, depression and disability status will be examined.Material and Methods: We enrolled 97 patients with multiple sclerosis, there were 36 men and 61 women with mean age (39.92 ± 9.11) All participants completed questionnaires: STOP-Bang, Fatigue Severity Scale (FSS), Epworth sleepiness scale (ESS), Beck Depression Invantery (BDI) and their disability was assessed using Expanded Disability Status Scale (EDSS). Polysomnographic sleep record was applied to patient with high risk of OSAS according to STOP-BANG test scores.Findings: Among patients, 24.7% screened as high risk for OSA based on STOP-BANG questionnaire. About 11.3% of patients detected positive for OSAS based on PSG recording. Comparing MS patients diagnosed with high risk of OSA and those without, there was significant difference between the two groups regarding age (p=0,01). ESS positive scores were significantly correlated with positive STOP BANG outcomes (p<0.001). ESS positive scores were negatively correlated with positive PSG outcomes.Results: The prevalance of OSAS in MS patients based on questionnaire and PSG was found consistent with literature. Similar to the general population, increasing age was found a risk factor for OSAS in patients with MS. STOP-BANG test may not be accurate test for diagnosing OSAS especially in MS patients with high fatigue scores.
ABSTRACTAim: The aim of this study is to determine the possible risk of OSAS in patients with MS using the STOP-BANG questionnaire, and to confirm the pre-diagnosis of OSAS by recording polysomnographic investigation in individuals with high risk. In addition, the relationship between OSAS risk and fatigue, sleepiness, depression and disability status will be examined.Material and Methods: We enrolled 97 patients with multiple sclerosis, there were 36 men and 61 women with mean age (39.92 ± 9.11) All participants completed questionnaires: STOP-Bang, Fatigue Severity Scale (FSS), Epworth sleepiness scale (ESS), Beck Depression Invantery (BDI) and their disability was assessed using Expanded Disability Status Scale (EDSS). Polysomnographic sleep record was applied to patient with high risk of OSAS according to STOP-BANG test scores.Findings: Among patients, 24.7% screened as high risk for OSA based on STOP-BANG questionnaire. About 11.3% of patients detected positive for OSAS based on PSG recording. Comparing MS patients diagnosed with high risk of OSA and those without, there was significant difference between the two groups regarding age (p=0,01). ESS positive scores were significantly correlated with positive STOP BANG outcomes (p<0.001). ESS positive scores were negatively correlated with positive PSG outcomes.Results: The prevalance of OSAS in MS patients based on questionnaire and PSG was found consistent with literature. Similar to the general population, increasing age was found a risk factor for OSAS in patients with MS. STOP-BANG test may not be accurate test for diagnosing OSAS especially in MS patients with high fatigue scores.