Factors affecting fatigue severity in patients with obstructive sleep apnea

Clin Respir J. 2017 Nov;11(6):1045-1051. doi: 10.1111/crj.12682. Epub 2017 Aug 14.

Abstract

Objectives: A limited number of studies have investigated the relationships among fatigue, insomnia and obstructive sleep apnea (OSA). This study evaluated the factors affecting fatigue severity in patients with OSA.

Methods: We investigated 633 OSA patients who were diagnosed by polysomnography. All patients completed sleep questionnaires including self-reported sleep duration, the Fatigue Severity Scale (FSS), the Korean version of Epworth Sleepiness Scale (K-ESS), Insomnia Severity Index (ISI), Korean version of Pittsburgh Sleep Quality Index (K-PSQI) and Beck Depression Inventory-2 (BDI-2).

Results: The subjects had a mean age of 48.7 ± 10.5 years and 72.5% (n = 459) were men. The subjects were distributed as follows: 160 with mild, 168 with moderate and 305 with severe OSA. A multiple regression model found that age (β = -0.146, P = .005), K-ESS (β = 0.689, P < .001), 8 ≤ ISI score < 15 (β = 3.801, P = .006), 15 ≤ ISI score (β = 4.565, P = .009), and K-PSQI (β = 0.684, P = .002) were predictors of a higher FSS score. BDI-2 (β = 0.007, P = .918), apnea-hypopnea index (AHI) (β = -0.006, P = .895), arousal index (β = 0.034, P = .415), and nadir O2 saturation (β = -0.044, P = .655) were not associated with FSS score.

Conclusion: Our findings indicate that fatigue severity is more likely to be associated with younger age, sleepiness and insomnia, but less likely to be directly related to OSA severity.

Keywords: fatigue; insomnia; obstructive sleep apnea; sleepiness.

MeSH terms

  • Adult
  • Disorders of Excessive Somnolence / complications*
  • Fatigue / diagnosis*
  • Fatigue / epidemiology
  • Fatigue / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Polysomnography / methods
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / complications
  • Sleep Apnea, Obstructive / diagnosis*
  • Sleep Apnea, Obstructive / epidemiology*
  • Sleep Apnea, Obstructive / physiopathology
  • Surveys and Questionnaires