To determine the clinical and psychological parameters in patients with obstructive sleep apnea syndrome (OSA) of varying severity and arterial hypertension (AH).Design and method:
The study involved 90 patients with OSA (76 men and 14 women, aged 56 ± 9.5 years) and AH. It included patients of the cardiological department with high predictive probability of OSA (Stradling questionnaire), and outpatients. Thus, the following patients were enrolled: 17 patients with mild OSA (5>apnea/ hypopnea index (AHI)<15) with a body mass index (BMI) 31.3 ± 1.9, 13 patients with moderate of OSA (15>AHI<30) with a BMI 33.4 ± 2.6, and 60 patients with severe (AHI>30) and BMI 35.47 ± 2.1. Diagnosis is based on cardiorespiratory monitoring (Somte Compumedics system, Australia). After the diagnosis of OSA was confirmed, patients filled questionnaires: WHOQOL, The Beck Depression Inventory, Spielberger's State Anxiety Inventory, Epworth Sleepiness Scale.Results:
A group of overweight or obese patients (14 people) with BMI>25, with severe daytime sleepiness and high baseline anxiety was singled out during analysis. All 14 people fell into the group of patients with severe OSA. This combination of factors has allowed to split the group with severe OSA into patients with a combination of these factors (14) and into patients without the combination of these factors (46). Using the Mann-Whitney test has revealed a statistically significant difference in the distribution of the following symptoms: AHI, desaturation index, the minimum saturation, anxiety, drowsiness. A group of 14 people had a higher AHI compared to a group of 46 people (63 ± 20.8 and 46 ± 18.5 resp.; p < 0.05), a higher index of desaturation (60 ± 19.6 and 45 ± 20.5 resp.; p < 0,05), a lower minimum saturation index (66 ± 8.5 and 73 ± 9.7 resp.; p < 0.05). Also higher level of anxiety (49.5 ± 3.4 and 46.1 ± 5.9 resp .; p < 0.05) and higher levels of sleepiness (12.7 ± 5 and 7 ± 3 7 resp.; p < 0.05) were found.Conclusions:
The presence of a combination of known factors, such as excessive weight and severe daytime sleepiness, along with high levels of anxiety, suggests more severe OSA progression.