title: Anxiety in middle-aged men with obstructive sleep apnea: state of the science.
abstract: OBJECTIVE
  This article presents the state of the science of anxiety in middle-aged men with obstructive sleep apnea (OSA). OSA affects 10% of men in this population. Psychological outcomes, especially anxiety, have a significant impact on quality of life, yet are essentially ignored.
  
  
  METHODS
  Search of CINAHL, MEDLINE, PsycINFO, and PsycARTICLES, with the key words "sleep apnea" and "anxiety" and with age and gender limits, resulted in 107 articles. Based on established inclusion criteria, 71 studies were excluded. The resulting 36 studies were critically evaluated by sample characteristics, anxiety measurement, and results.
  
  
  CONCLUSIONS
  Anxiety was noted in 34 of the 36 samples, most commonly measured using the Hospital Anxiety and Depression Scale, the State Trait Anxiety Inventory, and the Beck Anxiety Inventory. Effects of treatment on anxiety were significant.
  
  
  CONCLUSIONS
  Anxiety is common in middle-aged men with OSA, but is not adequately studied in this population. Psychological screening for anxiety at the time of OSA diagnosis is warranted, but is not encouraged in the clinical guidelines. More primary care attention is needed on psychological implications that impact OSA treatment adherence. Advanced practice nurses can be instrumental in ensuring comprehensive assessment of patients with OSA, especially psychological aspects of the disease.
authors.affiliation: School of Nursing, West Virginia University, Morgantown, West Virginia.
authors.forename: April L
authors.initials: AL
authors.lastname: Shapiro
mesh_terms: D001007:Anxiety / Q000209:etiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D020181:Sleep Apnea, Obstructive / Q000523:psychology*
keywords: Obstructive sleep apnea; anxiety; mental health; sleep disorders