OSA is a common disorder with significant neuropsychiatric morbidity. The objective of this study was to examine the prevalence of anxiety and depression in patients with OSA, and evaluate the effect of CPAP, and its influence on CPAP compliance.
Retrospective study. Charts of consecutive patients with OSA (AHI > 5) were reviewed. Patients were administered the Hospital Anxiety and Depression Scale (HADS) at baseline and on follow-up. CPAP compliance was monitored objectively using downloads –compliance was defined as > 4 hours of average nightly use after a minimum of 7 days of use.
199 patients meeting the inclusion criteria were initially administered the HADS questionnaire. The prevalence of anxiety and depression was high - 22.1% and 17% respectively. No differences in BMI or gender distribution was seen for those with and without anxiety and depression. Excessive sleepiness (ESS > 10) was more common in patients with anxiety (52.2% vs. 37.4%; p < 0.05) but not depression. Mean ESS in patients with anxiety was also higher (11.27 +/− 6.01 vs. 8.9 +/− 4.96; p < 0.05). Indices of OSA severity (AHI, O2 nadir) were similar in those with and without anxiety, and depression. 57 patients had follow-up CPAP compliance data. CPAP compliance was not significantly different in patients with or without depression, or anxiety. In these 57 patients, with documented CPAP use, 67% of anxiety patients and 100% of depression patients no longer scored positive for their respective components on HADS.
There is a high prevalence of anxiety and depression in patients with OSA. Presence of mood disorders does not influence CPAP compliance. CPAP treatment results in robust improvements in mood scales.
Physicians caring for patients with OSA should evaluate patients for both anxiety and depression, recognize that they may not be a major determinant of compliance, and may resolve with CPAP.
Swetha Bopparaju, No Financial Disclosure Information; No Product/Research Disclosure Information