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

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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.

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