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


OBJECTIVE
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.


CONCLUSIONS
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.
Department of Psychiatry, Institute of Clinical Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland. soili.lehto@kuh.fi
Soili Marianne
SM
Lehto
Johanna
J
Sahlman
Erkki Jaakko
EJ
Soini
Helena
H
Gylling
Esko
E
Vanninen
Juha
J
Seppä
Heimo
H
Viinamäki
Henri
H
Tuomilehto
D000328:Adult; D001007:Anxiety / Q000523:psychology* / Q000628:therapy*; D015992:Body Mass Index; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000523:psychology / Q000628:therapy; D040242:Risk Reduction Behavior; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000523:psychology* / Q000628:therapy*