Apnea and quality of life
The sleep is synonymous with quality of life, improved health and depletion of accidents. Disorders arising from the lack of quality or quantity of sleep now represent a global epidemiological problem. In one of the corners of this problem, sleep breathing disorders are a recognized public health problem. Recognizing the high prevalence of OSA, mainly of OSAHS in today's society, the last twenty years have been marked by an effort and priority concern of the medical community, which has invested many financial and human resources in research and dissemination of the health consequences of these pathologies. There is no argument to say, that all aspects of quality of life, physical health, mental and emotional health, vitality, social relationships and job performance are significantly compromised by the suffering of untreated obstructive sleep apnea. As it is clear from countless studies, sleep apnea contributes significantly to the deterioration of all health domains known as "quality of life." The concept of quality of life refers to a system of values, situations or perspectives estimated positive or considered desirable for people or communities, that vary from person to person. Quality of life is the feeling of wellbeing, that can be experienced by people and represents the sum of subjective feelings and the personal "feel good". There is no consensus on the definition of quality of life as it is the subjective estimation of the persons themselves, that quantify their own level of comfort and satisfaction, although there are different factors that influence the quality of life as age, health, level of economic resources, social status ...
The World Health Organization (WHO) defines health as:
One of the most flattering volunteer agents to achieve a state of physical and mental well being is sleep. The demonstrated relationship between the mechanisms of sleep and overall health of individuals is supported by numerous specialized research. Objectively analyzed, this relationship between the quality of life and quality of sleep has been the subject of a large number of publications. Zeitlhofer and et al.examinated the relationship between sleep quality and quality of life on a total sample of 1049 subjects aged 15 years. The authors managed the Sleep Quality Index in Pittsburgh (Pittsburgh Sleep Quality Index, PSQI), a questionnaire that evaluates the quality of sleep and its disorders. The results on sleep combined with the Index of Quality of Life (Quality of Life Index, QLI) used to assess the quality of life generally. The results of this study indicate, that subjects with good quality of sleep (sleep) (PSQI 5) have a better quality of life than those who report poor sleep. Furthermore, the quality of life was estimated as bad (QLI 3-5) or very bad(QLI 1-2), for bad sleepers (PSQI>8) and excellent sleepers (PSQI 9-10), for subjects with normal sleep hours (PSQI < 5). The authors found sufficient evidence to conclude, that, taking into account the high prevalence of sleep disorders and the close relationship between quality of life and quality of sleep, it could be determined that the quality of sleep is an indicator of quality of life.
Kojima et al. Also published in 2000 a study on the relationship between mortality and sleep, quantifying the length and quality of sleep. With a mixed sample of 5322 subjects (20-67 years), who completed a questionnaire about their subjective health status and lifestyle that included sleep patterns. The authors noted a relationship between different patterns of sleep and total mortality. In men with reduced sleep patterns, it was shown an increased risk of mortality compared with subjects with normal sleep patterns. (For an adult a day is considered normal sleep of 7-8 hours). More specifically, several studies have shown, that patients with sleep breathing disorders have reduced values of health related to values of quality of life.
Measurements on the quality of life in relation to sleep apnea, handle results through generic health questionnaires such as the Nottingham Health Profile and Short Form 36 (SF-36). The SF-36 is one of the instruments of quality of life related to health, HRQL (Health-related quality of life) most used. It is a generic scale that provides a health profile consisting of 36 questions assessing health states, both positive and negative. The questionnaire covers eight levels, which represent the most frequent concepts in health questionnaires, as well as aspects related to the disease and its treatment: physical function, physical role, body pain, general health, vitality, social function, emotional role and mental health. Specific questionnaires, such as Calgary Sleep Apnea, Quality of Life or Functional Outcomes of Sleep Questionnaire (FOSQ) are designed to quantify the interference of hypersomnolence in daily activities.
Epidemiological studies have found direct association between the severity of OSAHS and reduction in the scales, that manages the SF-36. Akashiba et al. analyzed in 2002 the quality of life of 60 apnea patients using the SF-36 questionnaire and found lower dates on most of the subgroups with apnea than those obtained by the control group of healthy subjects. Sforza et al. in 2003, evaluated health parameters related to quality of life by examining patients with respiratory disorders of sleep in order to establish a pattern of factors causing these disturbances. He studied 130 patients, 49 snorers and 81 with sleep apnea syndrome. Compared with normal values, the qualifications of OSAHS patients were lower at all levels on average values, with a greater decrease in partial results in the dimensions of "vitality", " physical role", "social function" "mental health" and "emotional role." The authors concluded that OSA patients had significantly worse results obtained average in every dimension compared with normative data. The greatest differences were found in "physical function", "vitality", "social function", " emotional role" and "mental illness."