Effect of sleep status on mood and daytime fatigue in patients with obstructive sleep apnea hypopnea syndrome complicating with stroke

Objective To investigate the impacts of sleep status on anxiety, depression, and daytime fatigue in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and stroke, and their correlations.

Methods A total of 112 stroke patients who were admitted to the Second Affiliated Hospital of Zhengzhou University from May 2022 to February 2023 were included, and were divided into stroke with OSAHS group (observation group, 54 cases) and stroke group (control group, 58 cases) according to the results of polysomnography (PSG). The observation group was divided into mild group (15 cases, stroke complicating with mild OSAHS) and moderate to severe group (39 cases, stroke complicating with moderate and severe OSAHS) according to the sleep apnea hypopnea index (AHI). All enrolled patients underwent PSG, and their sleep status was evaluated using AHI, arousal index, ratio of deep sleep (ratio of N3 sleep to total sleep time), nighttime average blood oxygen saturation (MSaO₂), and nighttime minimum blood oxygen saturation (LSaO₂); the daytime fatigue status of patients was evaluated using the Fatigue Severity Scale (FSS); patients'emotions were evaluated using the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD).

Results The awakening index, FSS score, HAMA score, and HAMD score of the observation group were higher than those of the control group, while the ratio of deep sleep, MSaO₂, and LSaO₂ were lower than those of the control group (P < 0.05); the awakening index, FSS score, HAMA score, and HAMD score of the moderate to severe group were higher, while the ratio of deep sleep, MSaO₂, and LSaO₂ were lower than those in the mild group (P < 0.05). The AHI in the observation group was positively correlated with arousal index, HAMA score, HAMD score, and FSS score (P < 0.05), but negatively correlated with deep sleep proportion, MSaO₂, and LSaO₂ (P < 0.05); the arousal index was positively correlated with HAMA score, HAMD score, and FSS score (P < 0.05); the ratio of deep sleep, MSaO₂, LSaO₂ were all negatively correlated with HAMA score, HAMD score, and FSS score (P < 0.05).

Conclusion The sleep status of stroke patients with OSAHS is worse than that of stroke patients alone, and there are correlations of sleep status with anxiety, depression, and daytime fatigue.