Abstract
Objective
The objective of this study was to determine potential inflammatory predictors of fatigue in obstructive sleep apnea (OSA).
Materials and methods
Fifty-six women and men untreated OSA patients had their sleep monitored with polysomnography. Fatigue was assessed by the Multidimensional Fatigue Symptom Inventory-Short Form. Depressed mood was assessed by the Center for Epidemiologic Studies-Depression Scale. Blood was drawn to assess circulating levels of Interleukin-6 (IL-6) and soluble tumor necrosis factor receptor I (sTNF-RI). Age, gender, body mass index (BMI), blood pressure, OSA severity, depressed mood, and inflammatory biomarkers were entered into a hierarchical multiple linear regression analysis predicting self-reported fatigue.
Results
Approximately 42% of the patients reported significant amounts of fatigue. Higher BMI (p = 0.014), greater depressed mood (p = 0.004), and higher sTNF-RI levels (p = 0.033) were independent predictors of fatigue in the final model (full model R 2 = .571; p = .003). Age, gender, blood pressure and apnea severity were unrelated to fatigue.
Conclusion
The findings suggest that in addition to depressed mood, fatigue in OSA may be associated with increased body weight and elevated levels of the proinflammatory cytokine receptor sTNF-RI. The findings support a linkage between the widely reported fatigue in OSA and a sleep-related component of inflammation.
This is a preview of subscription content, log in via an institution to check access.
References
Reimer MA, Flemons WW (2003) Quality of life in sleep disorders. Sleep Med Rev 7(4):335–349
Bardwell WA, Moore P, Ancoli-Israel S, Dimsdale JE (2003) Fatigue in obstructive sleep apnea: driven by depressive symptoms instead of apnea severity? Am J Psychiatry 160(2):350–355
Bower JE, Ganz PA, Aziz N, Fahey JL (2002) Fatigue and proinflammatory cytokine activity in breast cancer survivors. Psychosom Med 64(4):604–611
Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR (2007) Cancer-related fatigue: the scale of the problem. Oncologist 12(Suppl 1):4–10
Vgontzas AN, Papanicolaou DA, Bixler EO, Kales A, Tyson K, Chrousos GP (1997) Elevation of plasma cytokines in disorders of excessive daytime sleepiness: role of sleep disturbance and obesity. J Clin Endocrinol Metab 82(5):1313–1316
Stein KD, Jacobsen PB, Blanchard CM, Thors C (2004) Further validation of the multidimensional fatigue symptom inventory-short form. Journal of Pain and Symptom Management 27(1):14–23
Stein KD, Martin SC, Hann DM, Jacobsen PB (1998) A multidimensional measure of fatigue for use with cancer patients. Cancer Pract 6(3):143–152
Radloff LS (1977) The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401
Vgontzas AN, Bixler EO, Chrousos GP (2006) Obesity-related sleepiness and fatigue: the role of the stress system and cytokines. Ann NY Acad Sci 1083:329–344
Shearer WT, Reuben JM, Mullington JM et al (2001) Soluble TNF-alpha receptor 1 and IL-6 plasma levels in humans subjected to the sleep deprivation model of spaceflight. J Allergy Clin Immunol 107(1):165–170
Tracey KJ (2002) The inflammatory reflex. Nature 420(6917):853–859
Acknowledgments
This work was supported in part National Institutes of Health grants HL073355, HL44915 and CA23100 and the National Cancer Center Korea, Seoul, South Korea
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mills, P.J., Kim, JH., Bardwell, W. et al. Predictors of fatigue in obstructive sleep apnea. Sleep Breath 12, 397–399 (2008). https://doi.org/10.1007/s11325-008-0192-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11325-008-0192-8