E-ISSN : 2733-4538
Insomnia and depression are common to patients with obstructive sleep apnea syndrome (OSA). This study was conducted in order to explore the objective sleep characteristics, insomnia, and depressive symptoms of OSA and non-OSA patients and to provide clinical implications for diagnosis and treatment of OSA. A total of 145 patients (126 men, 19 women, average age: 49.56±12.06 years), who had been diagnosed as OSA, were administered polysomnography (PSG), the insomnia inventory, and the Beck Depression Inventory. The PSG showed that subjects in the OSA group had lower Sleep Efficiency (SE) and more difficulty in maintaining deep sleep than those in the non-OSA group. Although both the OSA and non-OSA groups had a significant level of insomnia and depressive symptoms, the non-OSA group showed more severe insomnia and depression than the OSA group. Correlation analysis was performed for identification of the significant indices of PSG relating to insomnia and depression. In the OSA group, patients who complained of more severe insomnia showed low SE and high Wakefulness After Sleep Onset (WASO). In addition, with greater depression, they showed high WASO and low Total Sleep Time (TST) and SE. However, in the non-OSA group, no correlation was observed between ISI or BDI and important sleep indices of PSG. Thus, for assessment of patients with OSA, it is necessary to examine not only physiological indices of the PSG but also the subjective clinical symptoms, such as insomnia and depression, so that we can anticipate problems that may occur during treatment and design tailored and efficient treatment plans.
강지호, 이상학, 권순석, 김영균, 김관형, 송정섭, 박성학, 문화식, 박용문 (2006). 한 대학병원에서 철야 수면다원검사를 시행한 환자들의 수면설문조사 결과 분석. 대한결핵 및 호흡기학회지, 60, 76-82.
공혜원, 이훈재, 최윤석, 나정호, 하충건, 황대웅, 김연옥, 윤창호 (2005). 폐쇄성 수면무호흡증의 임상적 예측인자들. 대한신경과학회지, 23, 324-329.
이다인, 이호원, 강병욱, 김준영, 김정수, 박성파. (2008). 폐쇄성 수면무호흡증 환자의 과도한 주간졸음의 예측인자. 대한수면연구회, 5(1), 43-48.
이선민, 이용주, 김지현. (2010). 한국인 폐쇄성 수면무호흡증 환자가 비강 양압기 사용시 흔하게 호소하는 불편감 및 순응도에 대한 단기추적 관찰연구. 대한수면연구회, 7(1), 1-7.
윤창호 (2004). 폐쇄성 수면 무호흡 증후군의 진단과 치료. 대한수면연구회, 1, 34-40.
이영호, 송종용 (1991). BDI, SDS, MMPI-D 척도의 신뢰도 및 타당도에 대한 연구. 한국심리학회지: 임상, 10, 98-113.
이호원 (2009). 수면질환을 진단할 때 병력과 수면 설문지의 역할. 대한수면연구회, 6, 1-3.
조용원 (2004). 수면척도와 수면위생. 대한수면연구회, 1, 12-23.
한경희, 임지영, 민병배, 이정흠, 문경주, 김중술 (2006). 한국판 MMPI-2의 개발 연구. 한국심리학회지: 임상, 25, 533-564.
한선정, 주은연, 김지현, 김민성, 홍승봉 (2004). 체질량지수, 목둘레와 폐쇄성 수면무호흡증후군 사이의 관련성. 대한수면연구회, 1, 37-41.
홍승봉, 주은연. (2004). 정상 수면(normal sleep)과 수면 장애 환자의 진찰. 대한수면연구회, 1(1), 1-5.
Aikens, J. E., Caruana-Montaldo, B., & Vanable, P. A. (1999). MMPI correlates of sleep and respiratory disturbance in obstructive sleep apnea. Sleep, 22, 362-369.
Aloia, M. S., Arnedt, J. T., Smith, L., Skrekas, J., Stanchina, M., & Millman, R. P. (2005). Examining the construct of depression in obstructive sleep apnea syndrome. Sleep Medicine, 6(2), 115-121.
American Academy of Sleep Medicine. (2001). The international classification of sleep disorders, reviesed: Diagnostic and coding manual. Chicago: American Academy of Sleep Medicine.
Bassiri, A. G. & Guilleminault, C. (2000). Clinical features and evaluation of obstructive sleep apnea-hypopnea syndrome. In M. H. Kryger, T. Roth, & W. C. Dement (3rd ed.). Principles and practice of sleep medicine (pp. 869 -878). Philadelphia: Saunders.
Bastien, C. H., Vallieres, A., & Morin, C. M. (2001). Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Medicine, 2, 297-307.
Bixler, E. O., Vgontzas, A. N., & Lin, H. M. (2001). Prevalence of sleep-disordered breathing in women: Effects of gender. American Journal of Respiratory and Critical Care Medicine, 163, 608-613.
Chung, K. F., Krakow, B., Melendrez, D., Warner, T. D., & Sisley, B. (2003). Relationships between insomnia and sleep-disordered breathing. Chest, 123, 310-311.
Dixon, J. B., Schachter, L. M., O’Brien, P. E. (2003). Predicting sleep apnea and excessive day sleepiness in the severely obese: Indicators for polysomnography. Chest, 123, 1134-1141.
Findley, L. J., Unvergat, M. E., & Suratt, P. M. (1988). Automobile accidents involving patients with obstructive sleep apnea. American Review of Respiratory Disorder, 138, 337-340.
Guilleminault, C. & Mittler, M. M. (1978). Clinical overview of sleep apnea syndromes. In A. R. Liss. Sleep Apnea Syndrome (p1). New York.
Guilleminault, C. (1990). Benzodiazepines, breathing, and sleep. American Journal of Medicine, 88, 25-28.
Guilleminault, C., Tilkian, A., & Dement, W. C. (1979). The sleep apnea syndromes. Annual Review of Medicine, 27, 465.
Krakow B., Melendrez, D., & Fereira E. (2001). Prevalence of insomnia symptoms in patients with sleep-disordered breathing. Chest, 120, 1923-1929.
Krell, S. B., & Kapur, V. K. (2005). Insomnia complaints in patients evaluated for obstructive sleep apnea. Sleep Breathing, 9, 104-110.
Miles, L. E. & Dement, W. C. (1980). Sleep and aging. Sleep, 3, 220.
Reynolds, C. F., Kupfer, D. J., McEachran, A. B., Taska, L. S., Sewitch, D. E., & Coble, P. A. (1984). Depressive psychopathology in male sleep apneics. Journal of Clinical Psychiatry, 45, 287-290.
Schafer, H., Koehler, U., Ploch, T., & Peter, J. H. (1997). Sleep-related myocardinal ischemia and sleep structure in patients with obstructive sleep apnea and coronary heart disease. Chest, 111, 387-393.
Stoohs, R. A., Bingham, L. A., Itoi, A., Guilleminault, C., & Dement, W. C. (1995). Sleep and sleep-disordered breathing in commercial long-haul truck drivers. Chest, 107, 1275-1282.
Strollo, P. J., & Rogers, R. M. (1996). Obstructive sleep apnea. New England Journal of Medicine, 334, 99-104.
Wells, R. D., Day, R. C., Carney, R. M., Freedland, K. E., & Duntley, S. P. (2004). Depression predicts self-reported sleep quality in patients with obstructive sleep apnea. Psychosomatic Medicine, 66, 692-697.
Yang, C., Liao, Y., Lin, C., Chou, S., & Wang, E. (2011). Psychological and behavioral factors in patients with comorbid obstructive sleep apnea and insomnia. Journal of Sleep Research, 70, 355-361.
Young, T., Peppard, P. E., & Gottlieb, D. J. (2002). Epidemiology of obstructive sleep apnea: A population health perspective. American Journal of Respiratory and Critical Care Medicine, 165, 1217-1239.
Yue, W., Hao, W., Liu, P., Ni, M., & Guo, Q. (2003). A case-control study on psychological symptoms in sleep apnea-hypopnea syndrome. Canadian Journal of Psychiatry, 48, 318-323.