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EFFECTS ON HEALTH
95
This severity comparison between different sleep anomalies was made in 2005 by
structured oral interviews, executed by a medical staff member of the sleep clinic of
Kantonsspital St. Gallen (Switzerland), with 14 GPs selected at random from all GPs
who had admitted patients to the sleep clinic during the nine preceding months.
These patients were mainly suffering from OSAS. The question was as follows:
“Could you please give us your opinion on the relative severity of three different
cases of insomnia:
1. (primary) insomnia, in our region usually called psychophysiological insomnia
2. Obstructive Sleep Apnoea Syndrome (OSAS)
3. traffic-noise-related sleep disturbance, that may occur with persons who are
forced to sleep along through roads with nocturnal motor traffic.
Your opinion should be based on the patients you have seen in your office lately,
or on other persons of your social environment. When comparing the severity
of the health impairment, the focus should be above all on the person’s condition
during the day after the sleep-disturbed night. The absolute value of the
severity is less important for the current study than the relative severity amongst
the three cases of insomnia. The opinion of the severity may be expressed on a
linear scale from 0 (no impairment at all) to 10 (impairment almost unsupportable).
On the scale from 0 to 10, you may give us your mean value of the severity,
or you may give us a span from a low to a high for the severity.”
All of the interviewed GPs gave their opinions, and the result is presented in Table
4.4.
Table 4.4
Severity ratings (10 = almost insupportably disturbing, 0 = not in the least disturbing)
by 14 GPs selected at random
Primary insomnia OSAS (sleep apnoea) Sleep disturb.(noise) Ratio noise/ Noise/
No Max Min Mean Rank Max Min Mean Rank Max Min Mean Rank priminsomnia OSAS
10 6 4 5 3 8 6 7 1 8 6 7 1 1.40 1.00
11 5 3 4 3 9 7 8 1 8 4 6 2 1.50 0.75
12 5 3 10 1 7 8 7.5 2 1.50 0.75
13 2 3 2.5 2 4 5 4.5 1 1 2 1.5 3 0.60 0.33
14 3 2 6 1 1 2 1.5 3 0.50 0.25
15 8 2 9 1 6 3 0.75 0.67
16 8 1 7 2 4 3 0.50 0.57
17 5 1 5 1 3 3 0.60 0.60
18 2 3 2.5 2 6 1 1 2 1.5 3 0.60 0.25
19 8 1 3 2 2 3 0.25 0.67
20 6 2 7 1 4 3 0.67 0.57
21 7 2 8 1 0 3 0.00 0.00
22 4 3 5 2 6 1 1.50 1.20
23 4 3 6 7 6.5 2 8 9 8.5 1 2.13 1.31
Mean
Sigma
Median
Upper value 95% C.l. for mean
Lower value 95% C.l. for mean
5.143 2.143 6.57 1.286 4.18 2.429 0.89 0.64
0.60
Clearly, the severity judgements vary widely between the participating GPs. Apart
from the differences in personal judgement, this variation is certainly influenced by
the mix of patients visiting a particular GP. For instance, GP number 15 could have
encountered one or two very serious cases of OSAS, whilst his/her experience with
noise-related sleep disturbance might refer to persons that were only moderately disturbed
by night-time noise in their bedroom. On the other hand, number 22 could
0.63
1.20
0.58
NIGHT NOISE GUIDELINES FOR EUROPE