Ömer GEÇİCİ, Mehmet ÜNLÜ, Murat SEZER, Fatma FİDAN, Ziya KARA

Uyku apne sendromlu hastalarda CPAP tedavisine uyum ve tedavinin anksiyete ve depresyon üzerine etkisi

Obstrüktif uyku apne sendromu (OUAS) çeşitli patofizyolojik değişikliklere yol açarak nöropsikolojik sistemi etkiler ve nazal sürekli pozitif hava yolu basıncı (CPAP) OUAS’nin en önemli tedavisidir. Çalışmamızda ağır OUAS olan hastalarda CPAP tedavisine uyumu değerlendirmeyi ve CPAP tedavisi öncesi ile tedavinin altıncı ayında anksiyete ve depresyon skorlarını karşılaştırmayı amaçladık. OUAS nedeniyle CPAP tedavisi verilen ve düzenli kontrollere gelen 17 hasta çalışmaya alındı. Hastalara ilk başvuruda ve CPAP tedavisinin altıncı ayında demografik özelliklerinin, OUAS semptomlarının sorgulandığı bir anket formu, uykululuğu belirlemek amacıyla Epworth uykululuk skalası ölçeği ve Beck anksiyete ve Beck depresyon ölçeği uygulandı. CPAP tedavisinin altıncı ayında ayrıca CPAP cihazına bağlı yan etkileri ve uyumu değerlendiren bilgiler elde edildi. Hastaların yaş ortalaması 48.4 ± 8.4 (32-63), 14 (%82.4)’ü erkek, 3 (%17.6)’ü kadın idi. CPAP tedavisi öncesine göre tedaviye başladıktan altı ay sonra yapılan değerlendirmede, horlama, tanıklı apne ve gündüz aşırı uyku hali semptomlarının, Epworth uykululuk skalası ölçeği puanının anlamlı olarak azaldığı bulundu. Hastaların CPAP cihazını geceleri takma süresi ortalama 5.6 ± 2.1 (2-8) saat idi. Hastaların 9 (%52.9)’u CPAP cihazını her gece kullandığını, geriye kalan 8 (%47.1)’i ise düzensiz olarak kullandıklarını ifade etti. Hastalarda CPAP tedavisi sırasında en sık görülen yan etki ağız kuruluğuydu, bunu maskeye bağlı rahatsızlık hissi ve burunda oluşan eritem izlemekteydi. Hastaların CPAP tedavisi öncesine göre, CPAP tedavisine başladıktan altı ay sonra anksiyete ve depresyon skorlarında anlamlı azalma saptandı. Sonuç olarak anksiyete ve depresyon skoru yüksek olan OUAS’li hastalar CPAP tedavisinden yarar görmektedir.

Compliance to CPAP treatment and effects of treatment on anxiety and depression in patients with obstructive sleep apnea syndrome

Obstructive sleep apnea syndrome (OSAS) causes numerous pathophysiological changes and influences neuropsychological system. Nasal continuous positive airway pressure (CPAP) is the gold standard treatment of OSAS. We aimed to evaluate the compliance of patients with severe OSAS to CPAP treatment and to compare the anxiety and depression scores before and at the 6th month of the treatment. Seventeen patients recieving CPAP treatment for OSAS that continued regular follow-up were accepted to the study. A questionnaire containing questions about demographic features, OSAS symptoms and Epworth sleepiness scale, Beck anxiety scale and depression scale was filled by the patients before and after CPAP treatment. Additionally, information concerning adverse effects of and compliance to CPAP treatment was optained after CPAP treatment. Mean age of the patients was 48.4 ± 8.4 (32-63); 14 (82.4%) of them were male and 3 (17.6%) of them were female. Snoring, witnessed apnea and excessive daytime sleepiness symptoms, and Epworth sleepiness scale scores were significantly decreased after CPAP treatment compared with those before treatment. Mean duration of CPAP device use at night was 5.6 ± 2.1 (2-8) hours. Nine (52.9%) of the patients were using the device regularly every night and 8 (47.1%) of the patients were using it irregularly. The most frequent adverse effect of CPAP treatment was sore mouth, followed by mask discomfort and erythema on the nose. Anxiety and depression scores of the patients were significantly decreased after CPAP treatment compared with those before the treatment. As a conclusion, OSAS patients with high anxiety and depression scores benefit from CPAP treatment.

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