0553 Prevalence of Insomnia and Anxiety in a National Sample of Patients with Obstructive Sleep Apnea and Depression

Abstract

Introduction Insomnia and anxiety are highly comorbid both with depression and with obstructive sleep apnea (OSA). This retrospective study sought to characterize patients with these conditions among a national sample of individuals with depression and comorbid OSA. Methods A national sample of administrative claims data of OSA patients was used for this analysis. Included patients either had two healthcare encounters or one hospitalization with a depression ICD-10 diagnosis code the year prior to OSA diagnosis and before initiation on positive airway pressure (PAP) therapy for treatment of OSA. Anxiety, insomnia, and other comorbidities were identified by the presence of at least one ICD-10 code associated with healthcare encounters in the year prior to starting PAP therapy. Age, sex, and insurance coverage were characterized at the time of the first OSA diagnostic sleep test. Healthcare resource utilization was assessed for the year prior to starting PAP therapy. Results 36,668 patients with depression and comorbid OSA were included. 56% had comorbid anxiety, 28% had comorbid insomnia, and 35% had neither anxiety nor insomnia. Compared to those without anxiety or insomnia, patients with anxiety or insomnia were more commonly female (64% vs 57%) and had a higher prevalence of asthma (25% vs 20%), psychotic (14% vs 7%) and other mood disorders (24% vs. 14%), fibromyalgia (11% vs 7%) and GERD (43% vs 33%). Relative to individuals with insomnia or anxiety, patients without insomnia or anxiety experienced fewer ER visits, all-cause hospitalizations, depression-related hospitalizations, specialist visits, and self-harm events in the year prior to PAP initiation. Relative to patients with comorbid insomnia, those with comorbid anxiety demonstrated slightly higher healthcare resource use in the year prior to PAP initiation. Conclusion Anxiety and insomnia are prevalent comorbidities in patients with depression and obstructive sleep apnea, with more than half of patients suffering comorbid anxiety and a quarter of patients having comorbid insomnia. Future research should examine comprehensive patient care strategies that can be used in patients with comorbid anxiety or insomnia to encourage healthy sleep behaviors and successful acclimation to OSA treatment. Support (if any) ResMed