To investigate whether patients with obstructive sleep apnoea (OSA) without excessive daytime sleepiness (EDS) have cardiovascular problems and different clinical characteristics to OSA with EDS.

Two groups of patients were compared retrospectively, one without EDS (Epworth<11) and another control group with EDS (Epworth>10), adjusted for sex, age, body mass index (BMI) and apnoea-hypopnoea index (AHI). The diurnal and nocturnal symptoms of OSA were analysed along with polysomnography variables, prevalence of hypertension, diabetes mellitus, hyperlipaemia, and history of previous cardiovascular events. After adjusting for multiple confounding factors, a logistic regression was performed to identify the variables associated with OSA without EDS.

A total of 166 patients without EDS were studied (Epworth 7.2 [2.4]) and 295 with EDS (Epworth 14.5 [2.5]). In the adjusted multivariate logistic regression, OSA without EDS is independently associated with a feeling of restful sleep (95%CI 1.70–3.93), less intellectual deterioration (95%CI, 0.30–0.95) and less effective sleep (95%CI, 0.96–0.99). No differences were found as regards prevalence of cardiovascular comorbidity, previous cardiovascular events, sleep structure, or nocturnal clinical symptoms of OSA. When the patients, who were in the extreme quartiles of the Epworth scale, were analysed, the results obtained were equivalent to those of the whole series, with only intellectual deterioration disappearing from the final model.

After adjusting for confounding variables, OSA without EDS has a similar prevalence of cardiovascular comorbidity and less diurnal symptoms than OSA with EDS.

Investigar si los pacientes con apneas obstructivas del sueño (AOS) sin somnolencia diurna excesiva (SDE) presentan problemas cardiovasculares y características clínicas diferentes de los AOS con SDE.

Se compararon retrospectivamente dos grupos de pacientes con AOS, uno de ellos sin SDE (Epworth < 11) y otro control con SDE (Epworth > 10), ajustados por sexo, edad, índice de masa corporal (IMC) e índice de apneas-hipopneas (IAH). Se analizaron síntomas diurnos y nocturnos de AOS, variables polisomnográficas, prevalencia de hipertensión arterial, diabetes mellitus, hiperlipemia y antecedentes de eventos cardiovasculares previos. Se realizó una regresión logística ajustada por múltiples factores de confusión para identificar variables asociadas al AOS sin SDE.

Se estudiaron 166 pacientes sin SDE (Epworth 7,2 ± 2,4) y 295 con SDE (Epworth 14,5 ± 2,5). En la regresión logística multiajustada, el AOS sin SDE se asoció de forma independiente con sensación de sueño reparador (IC95% 1,70 a 3,93), menor deterioro intelectual (IC95% 0,30 a 0,95) y menor eficacia del sueño (IC95% 0,96 a 0,99). No se encontraron diferencias en cuanto a prevalencia de comorbilidades cardiovasculares, eventos cardiovasculares previos, estructura de sueño o clínica nocturna de AOS. Cuando se analizaron los pacientes que se encontraban en los cuartiles extremos del Epworth, los resultados obtenidos fueron superponibles a los del total de la serie, desapareciendo únicamente el deterioro intelectual del modelo final.

Tras ajustar por variables de confusión, el AOS sin SDE tiene una prevalencia similar de comorbilidades cardiovasculares y menor sintomatología diurna que el AOS con SDE.