Daytime sleepiness is a cardinal symptom of obstructive sleep apnoea (OSA) and a well-recognised side effect of beta-blockers, therefore patients with OSA under this treatment may have worse sleepiness. However, the interaction between daytime sleepiness and beta-blockers use has not been thoroughly investigated in patients with OSA before. We analysed the data of 2183 individuals (1852 patients with OSA and 331 snorer controls) from 3 countries (Greece, Hungary and Moldova). Medical history, including medication usage and the Epworth Sleepiness Scale (ESS) were recorded. Patients and controls were divided into somnolent (ESS ≥ 11) and non-somnolent (ESS < 11) groups, and the association between-blocker use with the somnolent group was investigated with multivariate logistic regression analysis adjusted for confounders. Sensitivity analyses were performed in each cohort, in the severity subgroups, in patients who did not take statins and in those who had polysomnography as a diagnostic test. There was no relationship between beta-blocker usage and the somnolent OSA (p = 0.24) or control (p = 0.64) groups. These results were similar in sensitivity analyses (all p > 0.05). ESS was related to BMI (ρ = 0.25), total sleep time (ρ = 0.07), AHI (ρ = 0.32), oxygen desaturation index (ρ = 0.33) and minimum oxygen saturation (ρ = – 0.32, all p < 0.05) in OSA, and was higher in patients with hypertension, diabetes and cerebro/cardiovascular disease and those who took statins (all p < 0.05). In general, beta-blockers are not associated with increased daytime sleepiness in OSA. Thus, the diagnosis of OSA should not discourage initiation of beta-blocker treatment, if it is clinically indicated.

白天嗜睡是阻塞性睡眠呼吸暂停 (OSA) 的主要症状，也是 β 受体阻滞剂公认的副作用，因此在这种治疗下的 OSA 患者可能有更严重的嗜睡。然而，此前尚未在 OSA 患者中彻底研究白天嗜睡与使用 β 受体阻滞剂之间的相互作用。我们分析了来自 3 个国家（希腊、匈牙利和摩尔多瓦）的 2183 名个体（1852 名 OSA 患者和 331 名打鼾者对照）的数据。记录病史，包括药物使用和 Epworth 嗜睡量表 (ESS)。患者和对照被分为嗜睡（ESS ≥ 11）和非嗜睡（ESS < 11）组，并通过多变量逻辑回归分析对混杂因素进行调整，研究阻滞剂使用与嗜睡组之间的关联。在每个队列、严重程度亚组、未服用他汀类药物的患者和将多导睡眠图作为诊断测试的患者中进行了敏感性分析。β-受体阻滞剂的使用与嗜睡 OSA 之间没有关系（p  = 0.24) 或控制 ( p  = 0.64) 组。这些结果在敏感性分析中是相似的（所有p  > 0.05）。ESS 与 BMI ( ρ  = 0.25)、总睡眠时间 ( ρ  = 0.07)、 AHI ( ρ  = 0.32)、氧饱和度指数 ( ρ  = 0.33) 和最低氧饱和度 ( ρ  = – 0.32, 所有p  < 0.05) 相关在 OSA 中，高血压、糖尿病和脑/心血管疾病患者以及服用他汀类药物的患者更高（所有p < 0.05)。一般来说，β-受体阻滞剂与 OSA 患者白天嗜睡的增加无关。因此，如果有临床指征，OSA 的诊断不应阻止开始 β 受体阻滞剂治疗。