Sleepiness in obstructive sleep apnea: a harbinger of impaired cardiac function?

STUDY

OBJECTIVES

Daytime sleepiness is a common clinical presentation in both obstructive sleep apnea (OSA) and cardiovascular diseases. The purpose of this study was to assess the relationship between degree of subjective daytime sleepiness and cardiac performance in patients with obstructive sleep apnea.

DESIGN

Observational study.

SETTING

General Clinical Research Center.

PATIENTS: The study sample was comprised of 86 patients (68 men and 18 women) with an average age of 47 years. All were suspected of having obstructive sleep apnea and underwent confirmatory diagnostic polysomnography (respiratory disturbance index > or = 15).

MEASUREMENTS AND

RESULTS

Stroke volume and cardiac output were measured using impedance cardiography and corrected for body surface area to yield stroke index and cardiac index. Daytime sleepiness was quantified using the Epworth Sleepiness Scale. A higher Epworth Sleepiness Scale score, suggesting more daytime sleepiness, was significantly related to lower stroke index and cardiac index. In multiple regression analyses, the relationships of Epworth Sleepiness Scale score with both stroke index and cardiac index were significant (p < .05), even after controlling for age, sex, ethnicity, respiratory disturbance index, and mean sleep oxygen saturation.

CONCLUSIONS

These results suggest that daytime sleepiness is independently associated with decreases in cardiac function as assessed by impedance cardiography in patients with obstructive sleep apnea.