Impact of coping strategies on emotional status in patients with obstructive sleep apnea syndrome

Abstract

IntroductionObstructive sleep apnea syndrome (OSAS) is a common sleep disorder, which leads to higher morbidity, and mortality and can result in various psychological problems, such as depression.ObjectivesThe purpose of this study was to assess the severity of depression and to examine its relationships with coping strategies in OSAS patients.MethodsWe performed an analytical cross-sectional study of 87 recently diagnosed OSAS patients. Apnea hypopnea index (AHI) was determined by an overnight polysomnography. Depressive symptoms were evaluated by the hospital anxiety and depression scale (HADS). Coping strategies were assessed by the brief cope.ResultsSubjects included 38 men and 49 women averaging 55.7 years of age (SD = 11.6) with a mean body mass index (BMI) of 33.8 kg m−2. According to the AHI, 70.1% of the patients had severe OSAS, and 16.1% had moderate OSAS. Depressive symptoms were found in 44.8% of all patients. Emotional coping was used by 72.4%, while problem-focused coping was used by 28.7% of the patients. The score of depression on HADS (HADS-D) showed positive correlation with BMI (r = 0,48; P ≤ 0.001). No significant association was found between HADS-D and AHI. Depressive symptoms were associated with more emotional coping (P = 0.03) and with less problem-focused coping (P = 0.002).ConclusionOur findings suggest that depression is highly prevalent among patients with OSAS, and that coping style seems to have a significant influence on emotional status in these patients. Further research should explore the possibilities of intervening on this factor, aiming to lessen depressive symptoms in OSAS patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychological distress in patients with obstructive sleep apnoea: The role of hostility and coping self-efficacy

“…In contrast, Bardwell et al (2001) concluded that the more active and less passive the coping strategies reported by OSA patients are, the lower the level of depressive symptoms they experienced. Depressive symptoms were associated with more emotional coping and with less problem-focussed coping in the study by Gassara et al (2017). Although our results differ from those of previous studies (Bardwell et al, 2001; Gassara et al, 2017), these discrepancies may be associated with the difference in OSA diagnosis criteria; for example, patients in the study by Bardwell et al (2001) were diagnosed using a Respiratory Disturbance Index of ⩾15, while in our study, OSA diagnosis was stated based on an AHI of ⩾5.…”

“…A second model included a clinical variable (OSA severity – measured by AHI), and a third model included night-time sleep quality and daytime sleepiness. In the fourth and fifth model, hostility and all dimensions of CSE were included separately (following Bardwell et al, 2001; Gassara et al, 2017; Mikula et al, 2019) to assess the explained amount of the total variance of psychological distress.…”

“…Effective coping strategies may be beneficial in handling chronic diseases, including OSA (Bardwell et al, 2001; Gassara et al, 2017). Coping can be defined as an effort to manage a situation and involves various cognitive and behavioural strategies to overcome external or internal demands, which are appraised as either taxing or exceeding the person’s resources (Folkman et al, 1986).…”

“…Nevertheless, in some studies, avoidance-oriented coping, such as CSE for the ability to stop unpleasant emotions and thoughts, was defined as most effective in dealing with the disease (Harmell et al, 2011; Mackay et al, 2012). Recent studies have concluded that the more active and the less passive the coping strategies reported by OSA patients, the lower the level of depressive symptoms experienced by patients (Bardwell et al, 2001; Gassara et al, 2017). Moreover, a mediating role of CSE in the association between personality traits and psychological health was identified in patients with multiple sclerosis (Mikula et al, 2019).…”

“…To our knowledge, only two studies have directly focussed on the association between coping and self-rated health outcomes (i.e. depression) in OSA patients (Bardwell et al, 2001; Gassara et al, 2017). Due to a lack of general consensus regarding the continous positive airway pressure treatment effect on self-reported (Tippin et al, 2016; Weaver, 2013) and objective (Dimsdale et al, 2000) health outcomes, the present research and clinical practice should also focus on the identification of adequate internal resources which may diminish psychological distress in OSA patients.…”