Öz
Objective: Excessive Daytime Sleepiness (EDS) is a tendency to sleeping with increased fatigue during the day, following insufficient sleep at night. The aim of this study was to determine the relationship between obesity on depression and excessive sleepiness and to investigate the factors affecting them in women.
Method: The study was conducted with 385 randomly selected female participants between the ages of 18-65 who applied to our family medicine outpatient clinic for any reason. Sociodemographic characteristics and body mass index (BMI) of the participants were recorded. The Hospital Anxiety Depression Scale (HADS) and the Epworth Sleepiness Scale (ESS) were used.
Results: The mean age of the participants were 37.24±10.7 (18-63) years, mean BMI was 26.85±6.8 kg/m2. The mean ESS score was 8.50±4.4 point. According to the survey results of the HADS and ESS, obese women were found to have higher depression and daytime sleepiness than those with weak, normal and overweight and this difference was statistically significant (p<0.001). It was seen that 57.7% (n=60) of the 104 women with moderate / high ESS scores were obese, 20.2% (n=21) were overweight (p<0.001) and 82.7% (n=86) of these women had higher depression scores. As the BMI of the participants increased, there was an increase in depression symptoms and daytime sleepiness (p<0.001).
Conclusions: In our study, the prevalence of EDS in women was found to be 9.4%. As the level of obesity and depression increased, the incidence of GAUH increased. Prevention of obesity, which has become a social problem considering the principle of Preventive Medicine, which is one of the basic features of Family Medicine, will prevent obesity related both depression and sleep disorders.
Anahtar Kelimeler
Kaynakça
- 1. WHO. Physical Status: The Use and Interpretation of Anthropometry. Report of a WHO Expert Committee, WHO Technical Report Series. 1995.
- 2. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28(2):169–80.
- 3. Johns MW. A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale. Sleep 1991;14(6):540–5.
- 4. Dixon JB, Dixon ME, Anderson ML, Schachter L, Brien PEO, John B, et al. Risk Factors and Chronic Disease Daytime Sleepiness in the Obese : Not as Simple as Obstructive Sleep Apnea. Obesity. 2007;15(10):2504–11.
- 5. Bixler EO, Vgontzas AN, Lin HM, Calhoun SL, Vela-Bueno A, Kales A. Excessive daytime sleepiness in a general population sample: The role of sleep apnea, age, obesity, diabetes, and depression. J Clin Endocrinol Metab. 2005;90(8):4510–5.
- 6. Sabanayagam C SA. Sleep duration and cardiovascular disease: results from the National Health Interview Survey. Sleep 2010;33(8):1037–42.
- 7. Gooneratne NS, Richards KC, Joffe M, Lam RW PF, Staley B et al. Sleep disordered breathing with excessive daytime sleepiness is a risk factor for mortality in older adults. Sleep 2011;34(4):435–42.
- 8. Lopes JM, Dantas FG, Medeiros JLA de. Excessive daytime sleepiness in the elderly: association with cardiovascular risk, obesity and depression. Rev Bras Epidemiol 2013;16(4):872–9.
- 9. Fernandez-Mendoza J, Vgontzas AN, Kritikou I, Calhoun SL, Liao D, Bixler EO. Natural History of Excessive Daytime Sleepiness: Role of Obesity, Weight Loss, Depression, and Sleep Propensity. Sleep 2015;38(3):351–60.
- 10. Dixon JB, Schachter LM, O’Brien PE. Polysomnography before and after weight loss in obese patients with severe sleep apnea. Int J Obes(Lond). 2005; 29(9):1048-54.11. Chellappa SL, Schröder C, Cajochen C. Chronobiology, excessive daytime sleepiness and depression: Is there a link? Sleep Medicine 2009;10(5):505-14.
- 12. Aydemir Ö, Güvenir T, Küey L, Kültür S. Hastane Anksiyete ve Depresyon Ölçeği Türkçe Formunun Geçerlilik ve Güvenilirlik Çalışması. Türk Psikiyatr Derg 1997;8 (4):280-7.
- 13. Izci B, Ardic S, Firat H, Sahin A, Altinors M KI. Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale. Sleep Breath 2008;12(2):161.
- 14. MR L. Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep 2004;28(1):113–21.
- 15. Swanson LM, Arnedt JT, Rosekind MR et al. Sleep disorders and work performance: findings from the 2008 National Sleep Foundation Sleep in America poll. J Sleep Res 2011;20(3):487–94.
- 16. Sönmez S, Ursavaş A, Uzaslan E, Ediger D, Karadaǧ M, Gözü RO, et al. Vardiyalı çalışan hemşirelerde horlama, uyku bozuklukları ve i̇ş kazaları. Turk Toraks Derg 2010;11(3):105–8.
- 17. Chasens ER, Twerski SR, Yang K, Umlauf MG. Sleepiness and health in midlife women: Results of the national sleep foundation’s 2007 sleep in America poll. Behav Sleep Med 2010;8(3):157–71.
- 18. De Araújo TA, Mota MC, Crispim CA. Obesity and sleepiness in women with fibromyalgia. Rheumatol Int 2014;35(2):281–7.
- 19. Theorell-Haglöw J1, Lindberg E JC. What are the important risk factors for daytime sleepiness and fatigue in women? Sleep 2006;29(6):751–7.
- 20. Günes Z, Şahbaz M, Tuǧrul E, Günes H. Prevalence and risk factors for excessive daytime of sleepiness in rural western Anotolia (Turkey): The role of obesity and metabolic syndrome. Southeast Asian J Trop Med Public Health 2012;43(3):747–55.
- 21. Šiarnik P, Klobučníková, K Šurda P, Putala M, Šutovský S, Kollár B, Turčáni P. Excessive Daytime Sleepiness in Acute Ischemic Stroke: Association With Restless Legs Syndrome, Diabetes Mellitus, Obesity, and Sleep-Disordered Breathing. J Clin Sleep Med. 2018;15;14(1):95-100.
- 22. Ng WL, Stevenson CE, Wong E, Tanamas S, Boelsen-Robinson T, Shaw JE Does intentional weight loss improve daytime sleepiness? A systematic review and meta-analysis. Obes Rev. 2017;18(4):460-475.
- 23. Maugeri A, Medina-Inojosa JR, Kunzova S, Agodi A, Barchitta M, Sochor O, Lopez Jimenez F, Geda YE, Vinciguerra M. Sleep Duration and Excessive Daytime Sleepiness Are Associated with Obesity Independent of Diet and Physical Activity. Nutrients. 2018;3;10(9).
Öz
Amaç: Gündüz aşırı uykululuk hali (GAUH) gece alınan yetersiz uykuyu takiben gün içerisinde artmış yorgunluk ile uykuya eğilimli olma durumudur. Bu çalışmada kadınlarda obezitenin depresyon ve gündüz aşırı uykululuk durumu ile ilişkisini belirlemek ve etkileyen faktörleri araştırmak amaçlandı.
Yöntem: Çalışma aile hekimliği polikliniğimize herhangi bir nedenle başvuran 18-65 yaş arası rastgele seçilen 385 kadın katılımcı ile yapıldı. Katılımcıların sosyodemografik özellikleri sorgulandı ve beden kitle indeksleri (BKİ) kaydedildi. Hastane Anksiyete Depresyon Ölçeği (HADÖ) ve gündüz uykululuk halini belirlemek amacıyla Epworth Uykululuk Ölçeği (EUÖ) uygulandı.
Bulgular: Kadınların yaş ortalaması 37,24±10,7 (18-63) yaş, BKİ ortalaması 26,85±6,8 kg/m2 Epworth uykululuk ölçeği ortalaması 8,50±4,4 puan idi. HADÖ ve EUÖ sonuçlarına göre obez kadınların depresyon belirtileri ve gündüz uykululuk düzeyleri, zayıf, normal ve aşırı kilolu olanlara göre daha yüksek bulundu ve bu fark istatistiksel olarak anlamlıydı (p<0,001). EUÖ puanı orta/yüksek bulunan 104 kadının %57,7’si (n=60) obez, %20,2’si (n=21) aşırı kilolu idi (p<0,001). Kadınların %82,7’sinin (n=86) HADÖ'ne göre depresyon puanlarının yüksek olduğu görüldü. Katılımcıların BKİ’leri arttıkça depresyon belirtilerinde ve gündüz uykululuk durumunda artma görülmekte idi (R2=0,127, p<0,001).
Sonuç: Çalışmamızda kadınlarda GAUH sıklığı %9,4 olarak bulundu. Obezite ve depresyon düzeyi arttıkça GAUH görülme sıklığı da artıyordu. Aile Hekimliğinin temel özelliklerinden “Koruyucu Hekimlik” ilkesi göz önünde bulundurularak toplumsal bir sorun haline gelmiş obezitenin önlenmesi, obeziteye bağlı depresyon ve uyku bozukluklarının önüne geçecektir.
Anahtar Kelimeler
Kaynakça
- 1. WHO. Physical Status: The Use and Interpretation of Anthropometry. Report of a WHO Expert Committee, WHO Technical Report Series. 1995.
- 2. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28(2):169–80.
- 3. Johns MW. A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale. Sleep 1991;14(6):540–5.
- 4. Dixon JB, Dixon ME, Anderson ML, Schachter L, Brien PEO, John B, et al. Risk Factors and Chronic Disease Daytime Sleepiness in the Obese : Not as Simple as Obstructive Sleep Apnea. Obesity. 2007;15(10):2504–11.
- 5. Bixler EO, Vgontzas AN, Lin HM, Calhoun SL, Vela-Bueno A, Kales A. Excessive daytime sleepiness in a general population sample: The role of sleep apnea, age, obesity, diabetes, and depression. J Clin Endocrinol Metab. 2005;90(8):4510–5.
- 6. Sabanayagam C SA. Sleep duration and cardiovascular disease: results from the National Health Interview Survey. Sleep 2010;33(8):1037–42.
- 7. Gooneratne NS, Richards KC, Joffe M, Lam RW PF, Staley B et al. Sleep disordered breathing with excessive daytime sleepiness is a risk factor for mortality in older adults. Sleep 2011;34(4):435–42.
- 8. Lopes JM, Dantas FG, Medeiros JLA de. Excessive daytime sleepiness in the elderly: association with cardiovascular risk, obesity and depression. Rev Bras Epidemiol 2013;16(4):872–9.
- 9. Fernandez-Mendoza J, Vgontzas AN, Kritikou I, Calhoun SL, Liao D, Bixler EO. Natural History of Excessive Daytime Sleepiness: Role of Obesity, Weight Loss, Depression, and Sleep Propensity. Sleep 2015;38(3):351–60.
- 10. Dixon JB, Schachter LM, O’Brien PE. Polysomnography before and after weight loss in obese patients with severe sleep apnea. Int J Obes(Lond). 2005; 29(9):1048-54.11. Chellappa SL, Schröder C, Cajochen C. Chronobiology, excessive daytime sleepiness and depression: Is there a link? Sleep Medicine 2009;10(5):505-14.
- 12. Aydemir Ö, Güvenir T, Küey L, Kültür S. Hastane Anksiyete ve Depresyon Ölçeği Türkçe Formunun Geçerlilik ve Güvenilirlik Çalışması. Türk Psikiyatr Derg 1997;8 (4):280-7.
- 13. Izci B, Ardic S, Firat H, Sahin A, Altinors M KI. Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale. Sleep Breath 2008;12(2):161.
- 14. MR L. Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep 2004;28(1):113–21.
- 15. Swanson LM, Arnedt JT, Rosekind MR et al. Sleep disorders and work performance: findings from the 2008 National Sleep Foundation Sleep in America poll. J Sleep Res 2011;20(3):487–94.
- 16. Sönmez S, Ursavaş A, Uzaslan E, Ediger D, Karadaǧ M, Gözü RO, et al. Vardiyalı çalışan hemşirelerde horlama, uyku bozuklukları ve i̇ş kazaları. Turk Toraks Derg 2010;11(3):105–8.
- 17. Chasens ER, Twerski SR, Yang K, Umlauf MG. Sleepiness and health in midlife women: Results of the national sleep foundation’s 2007 sleep in America poll. Behav Sleep Med 2010;8(3):157–71.
- 18. De Araújo TA, Mota MC, Crispim CA. Obesity and sleepiness in women with fibromyalgia. Rheumatol Int 2014;35(2):281–7.
- 19. Theorell-Haglöw J1, Lindberg E JC. What are the important risk factors for daytime sleepiness and fatigue in women? Sleep 2006;29(6):751–7.
- 20. Günes Z, Şahbaz M, Tuǧrul E, Günes H. Prevalence and risk factors for excessive daytime of sleepiness in rural western Anotolia (Turkey): The role of obesity and metabolic syndrome. Southeast Asian J Trop Med Public Health 2012;43(3):747–55.
- 21. Šiarnik P, Klobučníková, K Šurda P, Putala M, Šutovský S, Kollár B, Turčáni P. Excessive Daytime Sleepiness in Acute Ischemic Stroke: Association With Restless Legs Syndrome, Diabetes Mellitus, Obesity, and Sleep-Disordered Breathing. J Clin Sleep Med. 2018;15;14(1):95-100.
- 22. Ng WL, Stevenson CE, Wong E, Tanamas S, Boelsen-Robinson T, Shaw JE Does intentional weight loss improve daytime sleepiness? A systematic review and meta-analysis. Obes Rev. 2017;18(4):460-475.
- 23. Maugeri A, Medina-Inojosa JR, Kunzova S, Agodi A, Barchitta M, Sochor O, Lopez Jimenez F, Geda YE, Vinciguerra M. Sleep Duration and Excessive Daytime Sleepiness Are Associated with Obesity Independent of Diet and Physical Activity. Nutrients. 2018;3;10(9).
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Dahili Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 21 Temmuz 2020 |
| Kabul Tarihi | 1 Temmuz 2020 |
| Yayımlandığı Sayı | Yıl 2020 |