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Undiagnosed obstructive sleep apnea in hypertensive outpatients in primary care—Associations with sleep complaints, depressive symptoms and global perceived health

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Open Journal of Nursing 2013年第6期3卷 445-452页

作者： Anders Brostrom ola sunnergren Kristofer Arestedt Peter Johansson Per Nilsen Bengt Fridlund Eva Svanborg Department of Nursing Science School of Health SciencesJonkoping UniversityJonkopingSweden Department of Clinical Neurophysiology Linkoping University HospitalLinkopingSweden Department of Clinical and Experimental Medicine Division of Clinical NeurophysiologyFaculty of Health SciencesLinkoping UniversityLinkopingSweden Department of ENT Ryhov HospitalJonkopingSweden School of Health and Caring Sciences Faculty of HealthSocial Work and Behavioural SciencesLinnaeus UniversityKalmarSweden Department of Medicine and Health Sciences Division of Nursing SciencesFaculty of Health SciencesLinkoping UniversityLinkopingSweden Department of Cardiology Linkoping University HospitalLinkopingSweden. Department of Medicine and Health Sciences Division of Cardiovascular MedicineFaculty of Health SciencesLinköping UniversityLinkopingSweden Division of Health Care Analysis Faculty of Health SciencesDepartment of Health and SocietyLinkoping UniversityLinkopingSweden

Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjective sleep complaints, depressive symptoms and global perceived health. Design: Cross-sectional design focusing on nursing care outcomes of obstructive sleep apnea. Setting: Four primary care health centres in Sweden. PATIENTS: 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed hypertension (BP > 140/90). Main Outcome Measures: Prevalence of OSA and depressive symptoms, and association of OSA to sleep complaints, depressive symptoms and global perceived health. RESULTS: Mild, moderate and severe OSA was seen among 29%, 16% and 14% of patients, respectively. Depressive symptoms were seen in 16% of the total group, with a higher prevalence among men, compared to women, 21% vs. 12%. No differences were found regarding blood pressure, estimated sleep need, sleep sufficiency index, insomnia symptoms, daytime sleepiness or depressive symptoms with respect to different degrees of OSA. Apnea-hypopnea index was significantly associated to perceived health after adjustment for gender and comorbidities, but when depressive symptoms and non-restorative sleep were added to the model, 33% of the variance in global perceived health was explained. Conclusion: OSA is highly prevalent among patients with hypertension in primary care and does together with sleep complaints and depressive symptoms have a negative impact on global perceived health. Hypertensive patients without subjective sleep complaints or depressive symptoms may still have OSA.

关键词： Depression Global Perceived Health Hypertension Nursing Care Obstructive Sleep Apnea Sleep Disordered Breathing Sleep

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