Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Analysis of Sleep Questionnaires of Patients who Performed Overnight Polysomnography at the University Hospital

한 대학병원에서 철야 수면다원검사를 시행한 환자들의 수면설문조사 결과 분석

  • Kang, Ji Ho (Department of Internal Medicine, The Catholic University of Korea, College of Medicine) ;
  • Lee, Sang Haak (Department of Internal Medicine, The Catholic University of Korea, College of Medicine) ;
  • Kwon, Soon Seog (Department of Internal Medicine, The Catholic University of Korea, College of Medicine) ;
  • Kim, Young Kyoon (Department of Internal Medicine, The Catholic University of Korea, College of Medicine) ;
  • Kim, Kwan Hyoung (Department of Internal Medicine, The Catholic University of Korea, College of Medicine) ;
  • Song, Jeong Sup (Department of Internal Medicine, The Catholic University of Korea, College of Medicine) ;
  • Park, Sung Hak (Department of Internal Medicine, The Catholic University of Korea, College of Medicine) ;
  • Moon, Hwa Sik (Department of Internal Medicine, The Catholic University of Korea, College of Medicine) ;
  • Park, Yong Moon (Department of Preventive Medicine, The Catholic University of Korea, College of Medicine)
  • 강지호 (가톨릭대학교 의과대학 내과학교실) ;
  • 이상학 (가톨릭대학교 의과대학 내과학교실) ;
  • 권순석 (가톨릭대학교 의과대학 내과학교실) ;
  • 김영균 (가톨릭대학교 의과대학 내과학교실) ;
  • 김관형 (가톨릭대학교 의과대학 내과학교실) ;
  • 송정섭 (가톨릭대학교 의과대학 내과학교실) ;
  • 박성학 (가톨릭대학교 의과대학 내과학교실) ;
  • 문화식 (가톨릭대학교 의과대학 내과학교실) ;
  • 박용문 (가톨릭대학교 의과대학 예방의학교실)
  • Received : 2005.11.02
  • Accepted : 2005.12.14
  • Published : 2006.01.30
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Abstract

Background : The objective of this study was to understand sleep-related problems, and to determine whether the sleep questionnaires is a clinically useful method in patients who need polysomnography. Methods : Subjects were patients who performed polysomnography and who asked to answer a sleep questionnaires at the Sleep Disorders Clinic of St. Paul's Hospital, Catholic University of Korea. Baseline characteristics, past medical illness, behaviors during sleep-wake cycle, snoring, sleep-disordered breathing and symptoms of daytime sleepiness were analyzed to compare with data of polysomnography. Results : The study population included 1081 patients(849 men, 232 female), and their mean age was $44.2{\pm}12.8years$. Among these patients, 38.9% had an apnea-hypopnea index(AHI)<5, 27.9% had $5{\leq}AHI<20$, 13.2% had $20{\leq}AHI<40$, and 20.0% had $40{\leq}AHI$. The main problems for visiting our clinic were snoring(91.7%), sleep apnea(74.5%), excessive daytime sleepiness(8.0%), insomnia(4.3%), bruxism(1.1%) and attention deficit(0.5%). The mean value of frequency of interruptions of sleep was 1.6 and the most common reason was urination(46.3%). Epworth Sleepiness Scale(ESS) had a weak correlation with AHI(r=0.209, p<0.01). When we performed analysis of sleep questionnaires, there were significant differences in the mean values of AHI according to the severity of symptoms including snoring, daytime sleepiness, taking a nap and arousal state after wake(p<0.05). Conclusion : On the basis of statistical analysis of sleep questionnaires, the severity of subjective symptoms such as ESS, snoring, daytime sleepiness and arousal state after wake correlated with the AHI significantly. Therefore the sleep questionnaires can be useful instruments for prediction of the severity of sleep disorder, especially sleep-disordered breathing.

연구배경 : 수면설문조사가 환자의 수면과 관련된 문제점을 파악하고 수면다원검사의 시행을 필요로 하는 환자를 선별하는 검사로써 임상적 유용성이 있는지 여부를 알아보고자 하였다 방 법 : 가톨릭대학교 성바오로병원 수면장애 클리닉에 의뢰되어 수면다원검사와 수면설문조사를 시행한 환자 를 대상으로, 수면설문조사에 포함되어 있는 환자의 일반적 특성, 병력, 수면-각성주기 동안의 행동, 코골이, 수면과 관련된 호흡장애 및 주간 졸음증과 관계된 증상 등 각각의 항목과 수면다원검사의 각 지표를 비교 분석하였다. 결 과 : 전체 환자수는 1081명으로 남자 849명, 여자 232명이었고 나이는 $44.2{\pm}12.8$세였다. AHI<5인 군은 38 .9%, $5{\leq}AHI<20$는 27.9%, $20{\leq}AHI<40$는 13.2% 그리고$AHI{\geq}40$는 20.0%였다. 검사를 시행하게 된 주된 동기는 코골이(91.7%), 무호흡(74.5%), 주간 졸음증(8.0%), 불면증(4.3%), 이갈이(1.1%), 집중력 장애(0.5%)였다. 수면 중 깨는 횟수는 평균 1.6회 였으며 그 이유는 소변을 보기 위함이 46.3%로 가장 많았다. Epworth Sleepiness Scale과 무호흡-저호흡지수(AHI)는 상관관계가 있었다(r=0.209, p<0.01). 수면설문 조사 항목 중 코골이, 주간 졸음증, 수면 후 각성 상태의 중증도에 따른 각 군간의 평균 AHI는 통계적으로 유의한 차이를 보였다. 결 론 : 수면설문조사에서 나타나는 ESS, 코골이, 주간 졸음증이나 수면 후 각성 상태 등 주관적 임상증상의 중증도는 수면다원검사 결과의 수면 무호흡의 중증도와 유의한 상관관계가 있음을 관찰할 수 있었다. 따라서 수면설문조사는 환자의 수면장애 특히 수면과 관련된 호흡장애의 정도를 예측하는데 유용하게 이용될 수 있을 것으로 생각한다.

Keywords

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