Assessment of the relationship between obstructive sleep apnea syndrome and sleep quality among dental students

Aims: Dental students are under the risk of developing sleep disorders due to intensive curriculum and long study hours. Hence, we aimed to assess the prevalance of obstuctive sleep apnea syndrome and its relation with sleep quality among Turkish dental students. Methods: A cross-sectional study was conducted among 314 dental students, who completed Epworth Sleepiness Scale (ESS) to identify the sleep quality (SQ) and excessive daytime sleepiness (EDS) and Berlin Questionnaire (BQ) for Obstructive Sleep Apnea Syndrome (OSAS). Demographic variables were also recorded. SPSS Version 23 (IBM Corporation, Armonk, NY, USA) was used for istatistical analysis. The statistical significance level was accepted as p<0.05. Results: OSAS risk was found to be 16.8% in Turkish dental students. Higher hypertension, obesity and body mass index (BMI) values were found to be related with higher risk for sleep apnea. There was a statistically significant positive correlation between ESS and BQ assessments (r=0.334, p<0.05). Normal daytime sleepiness was observed in 46.6% of dental students. Conclusion: OSAS risk was found to be high in dental students who will be the primary step in the diagnosis and treatment of sleep apnea. As the OSAS risk increases, sleep quality decreases. It should be emphasized that sleep and lifestyle habits may increase the risk of OSAS in dental students.

Keywords:

Sleep disorders, obstructive sleep apnea syndrome, sleep quality excessive daytime sleepiness, dental students,

PDF

___

Haavisto ML, Porkka-Heiskanen T, Hublin C, et al. Sleep restriction for the duration of a work week impairs multitasking performance. J Sleep Res. 2010;19(3):444-454. doi:10.1111/j.1365-2869.2010.00823.x
Azad MC, Fraser K, Rumana N, et al. Sleep disturbances among medical students: a global perspective. J Clin Sleep Med. 2015;11(1):69-74. doi:10.5664/jcsm.4370
Alhola P, Polo-Kantola P. Sleep deprivation: Impact on cognitive performance. Neuropsychiatr Dis Treat. 2007;3(5):553-567.
Ozer C, Etcibaşı S, Oztürk L. Daytime sleepiness and sleep habits as risk factors of traffic accidents in a group of Turkish public transport drivers. Int J Clin Exp Med. 2014;7(1):268-273.
Al Lawati NM, Patel SR, Ayas NT. Epidemiology, risk factors, and consequences of obstructive sleep apnea and short sleep duration. Prog Cardiovasc Dis. 2009;51(4):285-293. doi:10.1016/j.pcad.2008.08.001
Barger LK, Ayas NT, Cade BE, et al. Impact of extended-duration shifts on medical errors, adverse events, and attentional failures. PLoS Med. 2006;3(12):e487. doi:10.1371/journal.pmed.0030487
Weaver MD, Vetter C, Rajaratnam SMW, et al. Sleep disorders, depression and anxiety are associated with adverse safety outcomes in healthcare workers: A prospective cohort study. J Sleep Res. 2018;27(6):e12722. doi:10.1111/jsr.12722
Lund HG, Reider BD, Whiting AB, Prichard JR. Sleep patterns and predictors of disturbed sleep in a large population of college students. J Adolesc Health. 2010;46(2):124-132. doi:10.1016/j.jadohealth.2009.06.016
Chiu HY, Chen PY, Chuang LP, et al. Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: A bivariate meta-analysis. Sleep Med Rev. 2017;36:57-70. doi:10.1016/j.smrv.2016.10.004
Arıtürk Atılgan Z, Abakay A, Ülgen S. Obstructive sleep apnea syndrome and cardiovascular problems. Dicle Med J. 2011;38:253-256.
Senaratna CV, Perret JL, Matheson MC, et al. Validity of the Berlin questionnaire in detecting obstructive sleep apnea: a systematic review and meta-analysis. Sleep Med Rev. 2017;36:116-124. doi:10.1016/j.smrv.2017.04.001
Ulasli SS, Gunay E, Koyuncu T, et al. Predictive value of Berlin Questionnaire and Epworth Sleepiness Scale for obstructive sleep apnea in a sleep clinic population. Clin Respir J. 2014;8(3):292-296. doi:10.1111/crj.12070
Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999;131(7):485-491. doi:10.7326/0003-4819-131-7-199910050-00002
Sharma SK, Vasudev C, Sinha S, Banga A, Pandey RM, Handa KK. Validation of the modified Berlin questionnaire to identify patients at risk for the obstructive sleep apnoea syndrome. Indian J Med Res. 2006;124(3):281-290.
Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540-545. doi:10.1093/sleep/14.6.540
Alsaggaf MA, Wali SO, Merdad RA, Merdad LA. Sleep quantity, quality, and insomnia symptoms of medical students during clinical years. Relationship with stress and academic performance. Saudi Med J. 2016;37(2):173-182. doi:10.15537/smj.2016.2.14288
Léger D, Partinen M, Hirshkowitz M, Chokroverty S, Hedner J; EQUINOX (Evaluation of daytime QUality Impairment by Nocturnal awakenings in Outpatient's eXperience) Survey Investigators. Characteristics of insomnia in a primary care setting: EQUINOX survey of 5293 insomniacs from 10 countries. Sleep Med. 2010;11(10):987-998. doi:10.1016/j.sleep.2010.04.019
Chan-Chee C, Bayon V, Bloch J, Beck F, Giordanella JP, Leger D. Épidémiologie de l'insomnie en France : état des lieux. Rev Epidemiol Sante Publique. 2011;59(6):409-422. doi:10.1016/j.respe.2011.05.005
Kim EJ, Dimsdale JE. The effect of psychosocial stress on sleep: a review of polysomnographic evidence. Behav Sleep Med. 2007;5(4):256-278. doi:10.1080/15402000701557383
Belingheri M, Pellegrini A, Facchetti R, De Vito G, Cesana G, Riva MA. Self-reported prevalence of sleep disorders among medical and nursing students. Occup Med (Lond). 2020;70(2):127-130. doi:10.1093/occmed/kqaa011
Dos Santos ER, da Silva JHC, Lima AMJ, Studart-Pereira LM. Prevalence of predictive factors for obstructive sleep apnea in university students. Sleep Sci. 2022;15(Spec 1):234-238. doi:10.5935/1984-0063.20210008
Pasha SN, Khan UA. Frequency of snoring and symptoms of sleep apnea among Pakistani medical students. J Ayub Med Coll Abbottabad. 2003;15(1):23-25.
Amra B, Farajzadegan Z, Golshan M, Fietze I, Penzel T. Prevalence of sleep apnea-related symptoms in a Persian population. Sleep Breath. 2011;15(3):425-429. doi:10.1007/s11325-010-0353-4
Khazaie H, Najafi F, Rezaie L, Tahmasian M, Sepehry AA, Herth FJ. Prevalence of symptoms and risk of obstructive sleep apnea syndrome in the general population. Arch Iran Med. 2011;14(5):335-338.
Geiger-Brown J, Rogers VE, Trinkoff AM, Kane RL, Bausell RB, Scharf SM. Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses. Chronobiol Int. 2012;29(2):211-219. doi:10.3109/07420528.2011.645752
Seyedmehdi SM, Rahnama N, Yazdanparast T, et al. Prevalence of snoring and the risk of sleep apnea in hospital staff. Work. 2016;55(4):765-772. doi:10.3233/WOR-162460
Aydın Güçlü Ö, Karadağ M, İntepe YS, Acıcan T, Arslan S, Sertoğullarından B. Assessment of the risk of obstructive sleep apnoea syndrome among healthcare workers. Sağlık çalışanlarında obstrüktif uyku apne sendromu riskinin değerlendirilmesi. Tuberk Toraks. 2019;67(1):47-54. doi:10.5578/tt.68166
Yavuz F, Kabağıl B, İsmailoğulları S, Zararsız G, Per H. Tıp öğrencilerinde uyku bozuklukları sıklığının araştırılması ve sınıflara, cinsiyete ve vücut kitle indeksine göre değişiminin incelenmesi. J Turk Sleep Med. 2019;3:88-92.
Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc. 2008;5(2):136-143. doi:10.1513/pats.200709-155MG
Al Lawati NM, Patel SR, Ayas NT. Epidemiology, risk factors, and consequences of obstructive sleep apnea and short sleep duration. Prog Cardiovasc Dis. 2009;51(4):285-293. doi:10.1016/j.pcad.2008.08.001
Silverberg DS, Oksenberg A, Iaina A. Sleep-related breathing disorders as a major cause of essential hypertension: fact or fiction?. Curr Opin Nephrol Hypertens. 1998;7(4):353-357. doi:10.1097/00041552-199807000-00001
Fletcher EC, DeBehnke RD, Lovoi MS, Gorin AB. Undiagnosed sleep apnea in patients with essential hypertension. Ann Intern Med. 1985;103(2):190-195. doi:10.7326/0003-4819-103-2-190
Schwartz AR, Patil SP, Laffan AM, Polotsky V, Schneider H, Smith PL. Obesity and obstructive sleep apnea: pathogenic mechanisms and therapeutic approaches. Proc Am Thorac Soc. 2008;5(2):185-192. doi:10.1513/pats.200708-137MG
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328(17):1230-1235. doi:10.1056/NEJM199304293281704
Muñoz MDS, Dantas PPA, Pola NM, Casarin M, de Almeida RZ, Muniz FWMG. Poor quality of sleep is associated with lower academic performance in undergraduate dental students: a cross-sectional study. Sleep Vigil. 2023;1-10. doi:10.1007/s41782-022-00223-2
Caldeira FID, Cardoso B, Carvalho LS, Batista Ferreira E, Pigossi SC, Rodriguez LS. Perception of health-related quality of life, sleep quality and sleepiness index in an educational environment at a dental school in Southeast Brazil. Eur J Dent Educ. 2022;26(4):794-800. doi:10.1111/eje.12762
Curcio G, Ferrara M, De Gennaro L. Sleep loss, learning capacity and academic performance. Sleep Med Rev. 2006;10(5):323-337. doi:10.1016/j.smrv.2005.11.001
Ergin A, Aydemir-Acar G, Bekar T. Sağlıkla ilgili eğitim veren fakültelerdeki öğrencilerin uyku kalitesinin belirlenmesi. Pam Tıp Derg. 2018;11(3):347-54.