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Yıl:2020; Cilt: 7; Sayı: 3>> Özet
TAM METİN
Türk Uyku Tıbbı Dergisi; 2020;7(3):112-117
Stabil Kronik Obstrüktif Akciğer Hastalığında UykuKalitesi ve Obstrüktif Uyku Apne Sendromu RiskininDeğerlendirilmesi
BO Arslan, ZS Taymaz, ZZU Hoşgör, D Tatar
Dr. Suat Seren Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi, İzmir,
Amaç: Uyku kalitesi, Kronik Obstrüktif Akciğer hastalığı (KOAH) olan hastaların yaşam kalitesi ve sağlık sonuçlarını etkileyen önemli parametrelerden birisidir. Bu çalışmada stabil KOAH’li hastaların subjektif uyku kalitesi, uyku kalitesini etkileyen faktörler ve Obstrüktif Uyku Apne sendromu (OUAS) riskinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Hastanemiz göğüs hastalıkları polikliniğine başvuran ve stabil KOAH olarak değerlendirilen hastalar çalışmaya alındılar. Hastaların demografik özellikleri, eşlik eden hastalıkları, kullanmakta oldukları ilaçları kayıt altına alındı. Uyku kalitesini değerlendirmek amacı ile Pittsburgh Uyku Kalitesi indeksi (PUKİ) ve OUAS riskini değerlendirmek amacı ile de STOP-Bang anketi uygulandı. Anket sonuçlarına göre uyku kalitesi, uyku kalitesini etkileyen faktörler ve uyku apne sendromu riski değerlendirildi. Bulgular: Çalışmaya 67 (89,3) erkek, 8 (10,7) kadın olmak üzere toplam 75 hasta dahil edildi. Hastaların %38,7’sinin PUKİ >5 iken, %61,3’ünün PUKİ ≤5 olarak belirlendi. PUKİ’ye göre uyku kalitesi iyi ve kötü olan gruplar karşılaştırıldığında; hipertansiyon tanısı, gündüz aşırı uyku hali ve uyku etkinliği açısından anlamlı farklılık tespit edildi (p=0,005, p=0,049, p<0,001 sırasıyla). KOAH evreleri açısından farklılık izlenmedi (p=0,141). Bir PUKİ bileşeni olan “gece tuvalete gitmek” sorusundan, en fazla puan aldığı görüldü. STOP-Bang anketine göre 15 (%20) hasta OSA açısından düşük riskli, 27 (%36) orta riskli ve 33 (%44) yüksek riskli olarak tespit edildi. Sonuç: Stabil KOAH’lı hastaların %37,8’inin uyku kalitesinin kötü ve %44 hastanın OUA açısından yüksek risk grubunda olduğu tespit edilmiştir. Kötü uyku kalitesi olan hastaların subjektif uyku etkinliklerinin daha düşük ve hipertansiyon tanılarının daha fazla olduğu görülmüştür. Uyku kalitesini olumsuz etkileyen faktörlerden birinin “gece tuvalete gitmek” olduğu gözden kaçırılmamalıdır. Özellikle ileri yaş KOAH’li hastaların noktüri açısından sorgulanması altta yatan komorbid bir durumun ortaya çıkartılması kadar, uyku kalitesinde artışa neden olabilecek önlemlerin alınması yönünden de faydalı olabilir
Evaluation of the Sleep Quality and the Risk of Obstructive Sleep Apnea in Patientswith Stable Chronic Obstructive Pulmonary Disease
Objective: The purpose of this study is to evaluate the subjective sleep quality, factors affecting sleep quality, and the risk of Obstructive Sleep Apnea syndrome (OSAS) in the patients with stable Chronic Obstructive Pulmonary disease (COPD). Materials and Methods: We included the patients who were admitted to our chest diseases clinic and evaluated as stable COPD in the study. Pittsburgh Sleep Quality index (PSQI) and STOP-Bang survey were applied to the patients to evaluate the sleep quality and the risk for OSA. Results: We included 75 patients (67 males and 8 females) in this study. In total, 38.7% of the patients had a PSQI >5, whereas 61.3% of them had a PSQI =5. The comparison of groups revealed a significant difference in terms of diagnosis of hypertension, excessive daytime sleepiness, and sleep efficiency (p=0.005, p=0.049, p<0.001, respectively). There was no significant difference regarding the COPD stages between the groups (p=0.141). The question “to go to the toilet at night” from PSQI was the question had the highest score. According to the STOP-Bang score, 15 (20%) patients were identified at a low risk, 27 (36%) were at a medium risk, and 33 (44%) at a high risk for OSA. Conclusion: We determined that 37.8% of patients with stable COPD had a poor sleep quality and 44% of them were at a high risk for OSA. Patients with a poor sleep quality were more hypertensive and had lower subjective sleep efficacy. “To go to the toilet at night” was one of the factors that negatively affect sleep quality. Questioning patients with COPD at an advanced age in terms of nocturia can help in revealing an underlying co-morbid condition. Moreover, it is also important to implement measures that may lead to an increase in sleep quality.

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