Sleep-disordered breathing and quality of life in patients with chronic cerebrovascular diseas

Introduction. Chronic cerebrovascular disease (CeVD) is usually accompanied by a decrease in the quality of life (QoL). A possible cause of decreased QoL is sleep-disordered breathing.

Aim: to assess the frequency of sleep-related breathing disorders and QoL in patients with chronic CeVD.

Materials and methods. The study included 100 patients (50 men and 50 women), with an average age of 65 (58; 74.5) years. Cognitive (MoCA-test) and affective disturbances (HADS), severity of daytime sleepiness and fatigue (the Berlin questionnaire to identify patients at risk for the sleep apnea syndrome) were assessed. QoL was evaluated using the SF-36 health survey. Sleep-disordered breathing (SDB) was verified using cardiorespiratory monitoring. The apnoea/hypopnoea index was also calculated.

Results. On average, the cognitive impairment score was 25 (23, 27) points; the anxiety level was 6 (4; 9), depression level was 6 (3.5; 8), daytime sleepiness and fatigue were 4 (1.5; 7). QoL was reduced in the majority of patients. SDB was registered in 82% of patients. Multiple comparisons found no differences in QoL scores depending on the presence and severity of sleep-related breathing disorders. Patients with a history of stroke had higher scores for general health (p = 0.06), mental health (p = 0.01), and overall psychological health (p = 0.04). The stroke patients were younger (p = 0.02) and experienced less daytime sleepiness and fatigue (p = 0.007). Women had lower QoL scores compared to men. At the same time, the women were older than the men (p = 0.006) and had higher levels of anxiety (p = 0.0008). Statistically significant correlations were found between the various QoL components and age, anxiety and depression levels, severity of daytime sleepiness and fatigue, and cognitive dysfunction, but not the apnoea/hypopnoea index.

Conclusion. Patients with chronic ischaemic CeVD and SDB had reduced QoL; however, the mental health component remained slightly higher than the physical component. The main factors associated with a decrease in QoL were age, female gender, anxiety and depression levels, and excessive daytime sleepiness/fatigueo.