Relationships between obstructive sleep apnea and anxiety

Diaz, Shanna; Brown, Lee K.

doi:10.1097/mcp.0000000000000326

Cited by 25 publications

(11 citation statements)

References 60 publications

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“…Total prevalence of comorbid IAP syndromes and obstructive sleep apnea is still underrecognized and the coincidence of both groups of disorders is often overlooked [11]. Our results document rather a high proportion of IAP patients [47,22%], who are discouraged from continuous positive airway pressure therapy since their first in-lab titration night.…”

Section: Discussionmentioning

confidence: 69%

“…There are published numerous studies focusing on comorbid obstructive sleep apnea, sleep deprivation and anxiety/depression symptoms. Those studies analyzed the bidirectional relationship, symptoms severity, suggest therapy options and agree on urgent need of deeper research in this field [8,9,10,11]. Our observational study is first of its kind to evaluate both short-term and more importantly also the long-term clinical outcomes and CPAP ventilation therapy adherence of patients with comorbid obstructive sleep apnea and dyssomnias related to anxiety/internalizing disorders.…”

Section: Discussionmentioning

confidence: 81%

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Long term data on obstructive sleep apnea treatment in insomnia and anxiety related disorders - importance in the post-covid19 era?

Gavliakova

Bellova

Vitazkova

et al. 2021

OJMS

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Patients with comorbid neurotic and anxiety disorders are more receptive of the discomfort accompanying continuous positive airway pressure therapy than average obstructive sleep apnea patients. The purpose of the study was to analyze short-term and long-term continuous positive airway pressure therapy adherence data of patients with obstructive sleep apnea and comorbid anxiety and stress-related dyssomnias, as this group of disorders is expected to rise in the post-covid era. Study retrospectively analyzed clinical outcomes of obstructive sleep apnea patients. All subjects with obstructive sleep apnea were diagnosed based on in-lab video polysomnography, further referred to CPAP titration and were invited for regular follow-up visits. The results showed that subjects with comorbid obstructive sleep apnea and anxiety-related disorders used ventilation therapy more hours per day (6,690 hours/day vs. 5,000 hours/day, ****p<0,0001, anxiety (n=19) vs. controls (n=60)). Patients from the anxiety group remained longer in our therapy program (7,086 years vs. 2,905 years, ****p<0,0001) and had markedly better control over their weight, as the body-mass index of the control group increased by +1,065 kg/m2 per year and the body-mass index in the examination group increased only by +0,296 kg/m2 every year. Our data document that obstructive sleep apnea patients on ventilation therapy, who do not have enough control over their increasing body weight might highly benefit from therapy approaches similar to patients with anxiety-related dyssomnias and that management of obstructive sleep apnea is not an obstacle in concomitant treatment of neurotic and anxiety-related dyssomnias.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 81%

Long term data on obstructive sleep apnea treatment in insomnia and anxiety related disorders - importance in the post-covid19 era?

Gavliakova

Bellova

Vitazkova

et al. 2021

OJMS

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“…This may be because these conditions are associated with sleepiness and fatigue ( Corfield et al, 2016 ), in turn raising the suspicion of OSA for the referring doctors. A literature review published in 2016 reports that anxiety severity is related to OSA severity, suggesting that treating sleep-disordered breathing may improve anxiety symptoms ( Diaz and Brown, 2016 ). The relation between depression and OSA has been considered in former publications with conflicting results.…”

Section: Discussionmentioning

confidence: 99%

Association of Excessive Sleepiness, Pathological Fatigue, Depression, and Anxiety With Different Severity Levels of Obstructive Sleep Apnea

et al. 2022

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ObjectiveThe aim of this study was to investigate possible associations between obstructive sleep apnea and fatigue. This naturally led to considering the association between OSA and excessive sleepiness, depression, and anxiety.BackgroundOSA is a highly prevalent sleep disorder, associated with a risk of hypertension, cardiovascular events, daytime sleepiness, poor cognitive function, and sudden death during sleep. Both excessive sleepiness, fatigue, and symptoms of depression are frequently reported.Method5,464 patients referred to a university hospital for obstructive sleep apnea underwent standard respiratory polygraphy. The severity of OSA was defined as either mild, moderate, or severe, using the apnea–hypopnea index. Validated questionnaires were used to assess excessive sleepiness, pathological fatigue, depression, and anxiety.ResultsNearly 70% of the patients were men, and median age was 50 (range: 16–89) years. One in three had moderate-to-severe OSA (AHI ≥ 15). Excessive sleepiness and pathological fatigue were present in 43 and 39%, respectively. The prevalence of possible depression and anxiety was 19 and 28%, respectively. The proportion of patients with male sex, obesity, and excessive sleepiness increased with the severity of OSA. In contrast, the proportion of patients with pathological fatigue did not increase with OSA severity, and there was a decrease in depression and anxiety with increasing OSA severity.ConclusionOur study reports that pathological fatigue, as well as anxiety and depression, did not increase with OSA severity, whereas excessive sleepiness did. Knowledge concerning conditions related to OSA severity may be indicative of pretest probability of OSA and thus change the priority for polygraphy. Furthermore, the high prevalence rates of fatigue, anxiety, and depression among these patients warrant further investigations.

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“…Anxiety was found to intensify low-grade inflammation which could increase OSA symptoms [45]. Anxiety increases sympathetic nerve tone which with inflammatory mediators, can contribute to the pathogenesis of OSA and vice versa [46].…”

Section: Osa and Anxiety Disordermentioning

confidence: 99%

The relationships between obstructive sleep apnea and psychiatric disorders: a narrative review

Karakuła

Ryczkowski

Sitarz

et al. 2021

Current Problems of Psychiatry

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Introduction: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. Its prevalence tends to increase worldwide. Untreated sleep apnea is associated with a higher risk of metabolic diseases, cardiovascular diseases, stroke, road accidents, and death, but also it is suggested that it increases the risk of mental disorders. Method: The literature review was based on a search of articles on Medline, Pubmed, and Google Scholar from 2003 to 2021 using the keywords: obstructive sleep apnea; mental disorders; cognitive functions; affective disorders; depression; bipolar disorder; schizophrenia; psychotic disorders. The analysis included original studies, meta-analysis, and review articles. Discussion: The result obtained from researches published so far does not allow for drawing unequivocal conclusions. There is a lot of bias present in study protocols and inclusion/exclusion criteria. Nonetheless, it seems that some disorders have a better proven correlation with OSA. Cognitive impairment, depression, and anxiety disorders are linked to OSA not only in terms of the overlapping of symptoms but also of a causal relationship. Psychotic disorders and bipolar disorders connections with OSA are confirmed, but they are not yet well understood. All correlations are found to be possibly bidirectional. Conclusion: 1. Multiple lines of evidence increasingly point towards a bidirectional connection between OSA and mental disorders, and the cause and effect relationship between these two groups of disorders requires further research. 2. Due to reports of an increased risk of OSA with antipsychotic drugs, caution should be exercised when initiating therapy with this type of drug in patients with known risk factors for it. 3. Screening for OSA in psychiatric patients should be introduced as OSA can increase cognitive impairment, affective, and psychotic symptoms.

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Relationships between obstructive sleep apnea and anxiety

Cited by 25 publications

References 60 publications

Long term data on obstructive sleep apnea treatment in insomnia and anxiety related disorders - importance in the post-covid19 era?

Long term data on obstructive sleep apnea treatment in insomnia and anxiety related disorders - importance in the post-covid19 era?

Association of Excessive Sleepiness, Pathological Fatigue, Depression, and Anxiety With Different Severity Levels of Obstructive Sleep Apnea

The relationships between obstructive sleep apnea and psychiatric disorders: a narrative review

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