Turkiye Klinikleri Archives of Lung

.: ORIGINAL RESEARCH
Evaluation of the Daytime Sleepiness in Professional Male Drivers with Obstructive Sleep Apnea: A Clinical Study
Obstrüktif Uyku Apnesi Olan Profesyonel Erkek Sürücülerde Gündüz Uykululuğunun Değerlendirilmesi: Klinik Çalışma
Yeliz ÇELİKa
aKoç University Research Center for Translational Medicine, İstanbul, Türkiye
Turkiye Klinikleri Arch Lung. 2023;22(2):27-34
doi: 10.5336/archlung.2023-99539
Article Language: EN
Full Text
ABSTRACT
 Objective: The current study aimed to evaluate the excessive daytime sleepiness (EDS) in professional male drivers with obstructive sleep apnea (OSA) to increase the diagnostic utility of the sleep questionnaires. Material and Methods: Fifty-five professional male drivers completed the Epworth Sleepiness Scale (ESS) questionnaire and the Karolinska Sleepiness Scale (KSS) before and after a 50- minute simulator driving task. A hospital polysomnography was conducted to identify patients with OSA. The cutoff 11 on the ESS was used to categorized patients with EDS. The tertial groups were created to examine how the sleepiness levels change across the different ESS scores. Results: The median KSS scores increased significantly from 3 points (1-6) to 4 points (1-9) after the driving task. No group differences were found on the delta KSS scores between the patients with vs without EDS. Notwithstanding, there were significant differences between the tertial groups based on the ESS scores [0-4 (non-sleepy), 5- 9 (feeling of sleepy), and 10-16 (risk of dozing-off)] (p=0.04). The amount of change in sleepiness level among the first group was significantly lower than the second and the third tertial groups (p=0.02, p=0.004, respectively). In a multivariate regression analysis, the change in sleepiness on the KSS was associated with ESS [standard β=0.39 0.95% confidence interval (0.05-0.23), p=0.004]. The ROC curve analysis indicated that the ESS scores with a cut-off 5.5 had a sensitivity of 77% and a specificity of 66% to predict an increased sleepiness level. Conclusion: Drivers with OSA experienced the feeling of sleepiness should be considered as having EDS in the clinical management of OSA.

Keywords: Obstructive sleep apnea; sleepiness; driving
ÖZET
 Amaç: Mevcut çalışma, uyku anketlerinin tanısal faydasını artırmak için obstrüktif uyku apneli (OUA) profesyonel erkek sürücülerde gündüz aşırı uykululuk (GAU) hâlini değerlendirmeyi amaçladı. Gereç ve Yöntemler: Elli beş profesyonel erkek sürücü, Epworth Uykululuk Ölçeği (EUÖ) anketinin yanı sıra Karolinska Uykululuk Ölçeği'ni (KUÖ) 50 dk'lık simülatör sürüş görevi öncesinde ve sonrasında tamamladı. OUA'lı hastaları belirlemek için polisomnografi testi yapıldı. EUÖ'deki eşik puan 11, GAU'lu hastaları tanımlamak için kullanıldı. Farklı EUÖ puanlarının uykululuk durumuna etkisini araştırmak için 3 grup oluşturuldu. Bulgular: Medyan KUÖ puanı, sürüş sonrasında 3 puandan (1-6) 4 puana (1-9) önemli ölçüde arttı. KUÖ fark puanları, GAU'sı olan ve olmayan hasta gruplarında farklılık göstermedi. Öte yandan, EUÖ dikkate alarak oluşturduğumuz 3 grup arasında belirgin fark saptandı [0-4 (uykusuz), 5-9 (uykulu hissetme) ve 10-16 (uyuklama riski)] (p=0,004). Birinci gruptaki uykululuk düzeyindeki değişim miktarı, ikinci ve üçüncü gruplara göre anlamlı derecede düşüktü (p=0,02, p=0,004). Regresyon analizi, KUÖ fark puanları ile EUÖ puanları arasında bir ilişki olduğunu doğruladı [standart β=0,39, %95 güven aralığı (0,05-0,23), p=0,004]. ROC eğrisi, uykululuk hâlinin artması durumunu tahmin etmede 5,5 kesme noktasının %77 duyarlılık ve %66 özgüllük değeri ile öngördü. Sonuç: Uykululuk hissi yaşayan OUA'lı sürücüler, GAU hâli varmış gibi klinik olarak değerlendirilmelidir.

Anahtar Kelimeler: Obstrüktif uyku apnesi; uykululuk; sürüş
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