title: Somatic syndromes, insomnia, anxiety, and stress among sleep disordered breathing patients.
abstract: OBJECTIVE
  We tested the hypothesis that the prevalence of somatic syndromes, anxiety, and insomnia among sleep disordered breathing (SDB) patients is correlated with their levels of somatic arousal, the symptoms of increased sympathetic nervous system tone under conditions of stress.
  
  
  METHODS
  We administered the Body Sensation Questionnaire (BSQ; a 17-item questionnaire with increasing levels of somatic arousal scored 17-85) to 152 consecutive upper airway resistance syndrome (UARS) patients and 150 consecutive obstructive sleep apnea/hypopnea (OSA/H) patients. From medical records, we characterized each patient in terms of the presence of syndromes and symptoms into three categories: somatic syndromes (six syndromes), anxiety (anxiety disorders, nightmares, use of benzodiazepines), and insomnia (sleep onset, sleep maintenance, and use of hypnotics). For the pooled sample of SDB patients, we modeled the correlation of the BSQ score with the presence of each syndrome/symptom parameter within each of the three categories, with adjustment for male vs. female.
  
  
  RESULTS
  Mean BSQ scores in females were significantly higher than those in males (32.5 ± 11.1 vs. 26.9 ± 8.2; mean ± SD). Increasing BSQ scores significantly correlated with increasing prevalence rates of somatic syndromes (p < 0.0001), of anxiety (p < 0.0001), and of insomnia (p ≤ 0.0001). In general, females had higher prevalence rates of somatic syndromes and symptoms of anxiety than males at any BSQ score while rates of insomnia were similar.
  
  
  CONCLUSIONS
  In patients with SDB, there is a strong association between the level of somatic arousal and the presence of stress-related disorders like somatic syndromes, anxiety, and insomnia.
authors.affiliation: Division of Pulmonary/Critical Care/Sleep Medicine, Stony Brook University School of Medicine, Stony Brook, NY, 11794, USA.|DVA Medical Center, Northport, NY, 11768, USA.
authors.forename: Tshering
authors.initials: T
authors.lastname: Amdo
authors.affiliation: Division of Pulmonary/Critical Care/Sleep Medicine, Stony Brook University School of Medicine, Stony Brook, NY, 11794, USA.|DVA Medical Center, Northport, NY, 11768, USA.
authors.forename: Nadia
authors.initials: N
authors.lastname: Hasaneen
authors.affiliation: GlaxoSmithKline Consumer Health, Parsippany, NJ, 07054, USA.
authors.forename: Morris S
authors.initials: MS
authors.lastname: Gold
authors.affiliation: Division of Pulmonary/Critical Care/Sleep Medicine, Stony Brook University School of Medicine, Stony Brook, NY, 11794, USA. avram.gold@va.gov.|DVA Medical Center, Northport, NY, 11768, USA. avram.gold@va.gov.
authors.forename: Avram R
authors.initials: AR
authors.lastname: Gold
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D013223:Statistics as Topic; D013315:Stress, Psychological / Q000175:diagnosis* / Q000453:epidemiology*
keywords: Body Sensation Questionnaire; Central sensitization syndromes; Chronic stress; Sleep disordered breathing; Somatic arousal; Sympathetic nervous system; Upper airway resistance syndrome