Author/Authors :
Rezaeitalab, Fariborz Department of Neurology - School of Medicine - Mashhad University of Medical Sciences , Moharrari, Fatemeh Ibn-e- Sina Hospital - School of Medicine - Mashhad University of Medical Sciences, Mashhad , Saberi, Soheila University of Sydney - Sydney, Australia , Asadpour, Hadi Ibn-e- Sina Hospital - Mashhad University of Medical Sciences , Rezaeetalab, Fariba Imam Reza Hospital - School of Medicine - Mashhad University of Medical Sciences, Mashhad
Abstract :
Background: Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder characterized by repeated upper airway obstruction
during sleep. While respiratory pauses followed by loud snoring and daytime sleepiness are the main symptoms of OSAS, the patients
may complain from sleep disruption, headache, mood disturbance, irritability, and memory impairment. However, the association of
sleep apnea with anxiety and depression is not completely understood. Adherence to continuous positive airway pressure (CPAP), the
treatment of choice for OSAS, may be infl uenced by psychological conditions, especially claustrophobia. Th e aim of this study was to
evaluate the association of OSAS with anxiety and depression symptoms. Th is study also investigated the association of anxiety with body
mass index (BMI) and the severity of OSAS. Materials and Methods: We conducted a cross-sectional study on 178 adult individuals
diagnosed with OSAS at the sleep laboratory between September 2008 and May 2012. Th e participants were interviewed according to
a checklist regarding both their chief complaints and other associated symptoms. Th e psychological status was assessed according to
Beck anxiety inventory (BAI) and Beck depression inventory (BDI) scoring. Th e severity of breathing disorder was classifi ed as mild,
moderate, and severe based on apnea–hypopnea index (AHI) which was ascertained by overnight polysomnography. Daytime sleepiness
was assessed by Epworth sleepiness scale (ESS). Results: Th e mean (SD) age of participants was 50.33 years. In terms of sex, 85.5% of
the study population were males and14.4% were females. We found no relation between sex and the symptoms of OSAS. Regarding
the frequency of anxiety and depression symptoms, 53.9% of the individuals had some degree of anxiety, while 46.1% demonstrated
depressive symptoms. In terms of OSAS severity, this study showed that OSAS severity was associated with the frequency of anxiety,
chocking, and sleepiness (P : 0.001). According to polysomnographic results, we found that the majority of patients suff ering from
anxiety and chocking (66.7% and 71.4%, respectively) had severe OSAS, while only 23.1% of patients with sleepiness had severe OSAS.
Conclusion: Our study showed that the frequency of anxiety in OSAS patients is higher than in the general population regardless of
the gender. Furthermore, it is more likely that OSAS patients present with anxiety and depression than the typical symptoms.
