April - June 2011, Volume 7, Issue 2

Rusu A, Nita, Todea D, Rosca L, Bala C, Hancu N

Correlation of the Daytime Sleepiness with Respiratory Sleep Parameters in Patients with Sleep Apnea and Type 2 Diabetes

Acta Endo (Buc) 2011, 7 (2): 163-171
doi: 10.4183/aeb.2011.163

Objective. The aim of the study was to test whether a correlation exists between the Epworth Sleepiness Scale (ESS) and respiratory sleep parameters in patients with\r\ntype 2 diabetes.\r\nDesign. Subjects and Methods.The records of 83 consecutive patients (mean age 54.6? 9.8 years) with type 2 diabetes\r\nthat accepted to perform an in-hospital sleep study for screening of sleep apnea have been retrospectively evaluated.\r\nResults. There was a weak positive correlation between apnea/hypopnea index (AHI), oxygen desaturation index and ESS, and a weak negative correlation between ESS and mean O2 saturation. When data was separately analyzed in men and\r\nwomen, it could not be identified any correlation between sleep respiratory parameters and ESS in men. In women,\r\ncorrelation coefficients increased, proving a stronger relationship between ESS and AHI (r=0.65, p<0.001), mean O2 saturation (r=-0.52, p=0.005) and oxygen desaturation index (r=0.60, p=0.001). ESS had only a moderate level of accuracy in identifying patients with moderate and severe sleep\r\napnea (sensitivity 84.1%, specificity 74.1%, PPV 84.1%, NPV 74.1%). In women ESS showed a higher sensitivity than in men\r\n(92% vs. 80.6%), but a lower PPV (63% vs.78.1%) in predicting the presence of an AHI &#8805; 15.\r\nConclusions. In women with type 2 diabetes, it is possible to suspect the existence of SAS solely on the basis of the\r\nESS score. In male population, symptoms evaluated by questionnaires, such as the ESS, provide additional information which combined with clinical findings are helpful in selecting patients who are candidates for further detailed sleep studies.

Keywords: daytime sleepiness, diabetes, sleep apnea

Correspondence: Adriana Rusu, ?Iuliu Hatieganu? University of Medicine and Pharmacy Cluj-Napoca, Department of Diabetes, Nutrition, Metabolic Diseases, 2-4 Clinicilor Street, 400006 Cluj-Napoca, Romania, Phone: +40773081977; Fax: +40264594455, Email: adi.rusu@yahoo.com