ÖZET
Amaç:
Obstrüktif Uyku Apne sendromu (OSAS) hastalarında fiziksel aktivite (PA) katılımını etkileyen faktörleri inceleyen araştırmalara ihtiyaç vardır. Bu çalışmanın amacı, OSAS’li hastalarda PA düzeyi ile gündüz uyku hali, yorgunluk algısı, yaşam kalitesi ve psikolojik durum arasındaki ilişkiyi araştırmaktır.
Gereç ve Yöntem:
Bu kesitsel çalışma, 30-60 yaşları arasında 38 OSAS’li hastayı kapsamaktadır. PA seviyesi, Uluslararası Fiziksel Aktivite Anketinin (IPAQ) Türkçe versiyonu kullanılarak belirlendi. Yaşam kalitesi Uykunun Fonksiyonel Sonuçları Ölçeği ve Nottingham Sağlık Profili (NHP) ile değerlendirildi. Uykululuk durumunu değerlendirmek için Epworth Uykululuk Ölçeği (EUÖ) kullanıldı. Yorgunluk algısı Yorgunluk Etki Ölçeği (FIS) ve Yorgunluk Şiddeti Ölçeği (FSS) ile değerlendirildi.
Bulgular:
IPAQ sınıflandırmasına göre, hastaların %44,7’si inaktifti. IPAQ-total skoru ile EUÖ skoru (r=-0,493, p=0,002); Hastane Anksiyete ve Depresyon Ölçeği-A skoru (r=-0,338, p=0,041); NHP-sosyal izolasyon puanı (r=-0,406, p=0,013); FIS-fiziksel skoru (r=-0,404, p=0,013) ve FISpsikososyal skoru (r=-0,411, p=0,012) arasında belirgin bir korelasyon gözlendi.
Sonuç:
Bu çalışma, OSAS’li hastalarda toplam PA miktarının aşırı gündüz uykululuk hali, kaygı düzeyi, sosyal izolasyon ve yorgunluğun fiziksel ve psikososyal işlevler üzerindeki etkileriyle yakından ilişkili olduğunu göstermiştir.
References
1
Lurie A. Obstructive sleep apnea in adults: epidemiology, clinical presentation, and treatment options. Adv Cardiol 2011;46:1-42.
2
Epstein LJ, Kristo D, Strollo PJ Jr, Friedman N, Malhotra A, Patil SP, Ramar K, Rogers R, Schwab RJ, Weaver EM, Weinstein MD; Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 2009;5:263-76.
3
Chwiesko-Minarowska S, Minarowski L, Kuryliszyn-Moskal A, Chwiesko J, Chyczewska E. Rehabilitation of patients with obstructive sleep apnea syndrome. Int J Rehabil Res 2013;36:291-7.
4
Desplan M, Mercier J, Sabate M, Ninot G, Prefaut C, Dauvilliers Y. A comprehensive rehabilitation program improves disease severity in patients with obstructive sleep apnea syndrome: a pilot randomized controlled study. Sleep Med 2014;15:906-12.
5
Chervin RD. Sleepiness, fatigue, tiredness, and lack of energy in obstructive sleep apnea. Chest 2000;118:372-9.
6
Bardwell WA, Moore P, Ancoli-Israel S, Dimsdale JE. Fatigue in obstructive sleep apnea: driven by depressive symptoms instead of apnea severity? Am J Psychiatry 2003;160:350-5.
7
Hong S, Dimsdale JE. Physical activity and perception of energy and fatigue in obstructive sleep apnea. Med Sci Sports Exerc 2003;35:1088-92.
8
Verwimp J, Ameye L, Bruyneel M. Correlation between sleep parameters, physical activity and quality of life in somnolent moderate to severe obstructive sleep apnea adult patients. Sleep Breath 2013;17:1039-46.
9
Igelstrom H, Emtner M, Lindberg E, Asenlof P. Physical activity and sedentary time in persons with obstructive sleep apnea and overweight enrolled in a randomized controlled trial for enhanced physical activity and healthy eating. Sleep Breath 2013;17:1257-66.
10
Consultation WHOE. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157-63.
11
Hori T, Sugita Y, Koga E, Shirakawa S, Inoue K, Uchida S, Kuwahara H, Kousaka M, Kobayashi T, Tsuji Y, Terashima M, Fukuda K, Fukuda N; Sleep Computing Committee of the Japanese Society of Sleep Research Society. Proposed supplements and amendments to ‘A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects’, the Rechtschaffen & Kales (1968) standard. Psychiatry Clin Neurosci 2001;55:305-10.
12
Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999;22:667-89.
13
Kushida CA, Littner MR, Morgenthaler T, Alessi CA, Bailey D, Coleman J Jr, Friedman L, Hirshkowitz M, Kapen S, Kramer M, Lee-Chiong T, Loube DL, Owens J, Pancer JP, Wise M. Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep 2005;28:499-521.
14
Medicine ACoS. ACSM’s Health-Related Physical Fitness Assesment Manual 4th ed. ed. China: Lippincott Williams&Wilkins; 2014.
15
Durnin JV, Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr 1974;32:77-97.
16
Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E, Tokgozoglu L. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills 2010;111:278-84.
17
Singh SJ, Puhan MA, Andrianopoulos V, Hernandes NA, Mitchell KE, Hill CJ, Lee AL, Camillo CA, Troosters T, Spruit MA, Carlin BW, Wanger J, Pepin V, Saey D, Pitta F, Kaminsky DA, McCormack MC, MacIntyre N, Culver BH, Sciurba FC, Revill SM, Delafosse V, Holland AE. An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease. Eur Respir J 2014;44:1447-78.
18
Kucukdeveci AA, McKenna SP, Kutlay S, Gursel Y, Whalley D, Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res 2000;23:31-8.
19
Izci B, Firat H, Ardic S, Kokturk O, Gelir E, Altinors M. Adaptation of functional outcomes of sleep questionnaire (FOSQ) to Turkish population. Tuberk Toraks 2004;52:224-30.
20
Izci B, Ardic S, Firat H, Sahin A, Altinors M, Karacan I. Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale. Sleep Breath 2008;12:161-8.
21
Theander K, Cliffordson C, Torstensson O, Jakobsson P, Unosson M. Fatigue Impact Scale: Its validation in patients with chronic obstructive pulmonary disease. Psychol Health Med 2007;12:470-84.
22
Armutlu K, Korkmaz NC, Keser I, Sumbuloglu V, Akbiyik DI, Guney Z, Karabudak R. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. Int J Rehabil Res 2007;30:81-5.
23
Aydemir Ö GT, Küey L, Kültür S. Hastane Anksiyete ve Depresyon Ölçeği Türkçe Formunun Geçerlilik ve Güvenilirlik Çalışması. Türk Psikiyatri Dergi 1997;8:280-7.
24
Green SB, Salkind NJ. Using SPSS for Windows and Macintosh: Analyzing and Understanding Data. 7th ed. United States of America: Pearson; 2013.
25
Hayran M, Hayran M. Sağlık Araştırmaları İçin Temel İstatistik. 1st ed. Ankara: Omega Yayınları; 2011.
26
Domholdt E. Physical Therapy Research: Principles and Applications. 2nd ed. Philadelphia: WB Saunders; 2000.
27
Johns MW. What Is Excessive Daytime Sleepiness? In: Fulke P, Vaughan S, editor. Sleep Deprivation: Causes, Effects and Treatment New York: Nova Science Inc; 2009. p. 59-94.
28
Beitler JR, Awad KM, Bakker JP, Edwards BA, DeYoung P, Djonlagic I, Forman DE, Quan SF, Malhotra A. Obstructive sleep apnea is associated with impaired exercise capacity: a cross-sectional study. J Clin Sleep Med 2014;10:1199-204.
29
Ucok K, Aycicek A, Sezer M, Genc A, Akkaya M, Caglar V, Fidan F, Unlu M. Aerobic and anaerobic exercise capacities in obstructive sleep apnea and associations with subcutaneous fat distributions. Lung 2009;187:29-36.
30
Butner KL, Hargens TA, Kaleth AS, Miller LE, Zedalis D, Herbert WG. Association of Obstructive Sleep Apnea Severity with Exercise Capacity and Health-related Quality of Life. N Am J Med Sci 2013;5:362-6.
31
Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A; American College of Sports Medicine; American Heart Association. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 2007;116:1081-93.
32
Sauter C, Asenbaum S, Popovic R, Bauer H, Lamm C, Klosch G, Zeitlhofer J. Excessive daytime sleepiness in patients suffering from different levels of obstructive sleep apnoea syndrome. J Sleep Res 2000;9:293-301.
33
Macey PM WM, Kumar R, Cross RL, Harper RM. . Relationship between Obstructive Sleep Apnea Severity and Sleep, Depression and Anxiety Symptoms in Newly-Diagnosed Patients. PLoS ONE 2010;5:e10211.
34
Sforza E, Janssens JP, Rochat T, Ibanez V. Determinants of altered quality of life in patients with sleep-related breathing disorders. Eur Respir J 2003;21:682-7.
35
Asghari A, Mohammadi F, Kamrava SK, Jalessi M, Farhadi M. Evaluation of quality of life in patients with obstructive sleep apnea. Eur Arch Otorhinolaryngol 2013;270:1131-6.
36
Ogutmen B, Yildirim A, Sever MS, Bozfakioglu S, Ataman R, Erek E, Cetin O, Emel A. Health-related quality of life after kidney transplantation in comparison intermittent hemodialysis, peritoneal dialysis, and normal controls. Transplant Proc 2006;38:419-21.
37
Bauman A, Ainsworth BE, Sallis JF, Hagstromer M, Craig CL, Bull FC, Pratt M, Venugopal K, Chau J, Sjöström M; IPS Group. The descriptive epidemiology of sitting. A 20-country comparison using the International Physical Activity Questionnaire (IPAQ). Am J Prev Med 2011;41:228-35.
