The association between anxiety and the degree of illness in mild obstructive sleep apnoea

Clin Respir J. 2013 Apr;7(2):197-203. doi: 10.1111/j.1752-699X.2012.00304.x.

Abstract

Introduction: Obstructive sleep apnoea (OSA) has been reported to associate with anxiety, but earlier observations are scarce and the role of the persistence of anxiety in this connection is unclear.

Objectives: To examine the associations between OSA and anxiety, and in particular clarify the observations regarding the role of the persistence of anxiety in this connection.

Methods: A total of 61 overweight patients with mild OSA participated in a 12-month lifestyle modification study and reported the presence of anxiety both at baseline and on 12-month follow up. They were divided into three groups (no anxiety, n = 25; past anxiety, n = 13; persistent anxiety, n = 23), and the degree of illness was assessed with the apnoea-hypopnea index (AHI).

Results: The persistence of anxiety was linearly associated with the AHI (P = 0.025), which was highest in individuals with persistent anxiety. The likelihood of belonging to the group with persistent anxiety increased 18% for each one-unit increase in the AHI in a model adjusted for age, gender and bodyfat % (odds ratio 1.18, 95% confidence interval 1.03-1.34, P = 0.014). Further adjustments for daytime sleepiness and the effect of participating in the lifestyle modification intervention did not alter this finding.

Conclusion: Our observations suggest that the persistence of anxiety is independently associated with elevated levels of sleep-disordered breathing and that lifestyle modification interventions with a focus on diet and exercise alone may not be sufficient to treat OSA in individuals with simultaneous persistent anxiety.

Trial registration: ClinicalTrials.gov NCT00486746.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anxiety / psychology*
  • Anxiety / therapy*
  • Body Mass Index
  • Female
  • Health Promotion / methods
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Overweight / psychology
  • Overweight / therapy
  • Risk Reduction Behavior
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / psychology*
  • Sleep Apnea, Obstructive / therapy*

Associated data

  • ClinicalTrials.gov/NCT00486746