Anxiety in middle-aged men with obstructive sleep apnea: State of the science

Abstract

Purpose 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. Data sources 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. Implications for practice 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.

Lifestyle and Occupational Stress: A Potential Risk Factor for Obstructive Sleep Apnea in Nonobese Male Subjects

“…29 Earlier studies have shown that stress initiates and aggravates tissue inflammation. [12][13][14][15][21][22][23][24][25][26][27][28][29][30] Elevated serum levels of cortisol and CRP found in all the patients in this study replicated the finding of previous studies. [6][7][8] Upper airway endoscopy of the entire study sample of 30 patients revealed the presence of a specific co-morbidity of upper airway inflammation, as reported by others in the past.…”

“…Chronic stress, along with hypoxic stress (due to recurrent hypoxia), further aggravates tissue inflammation. Upper airway inflammation and constriction may contribute to OSA …”

“…Upper airway inflammation and constriction may contribute to OSA. [16][17][18][19][20][21] Use of oral appliance therapy to treat OSA patients, both dentate and edentulous, is a daunting challenge to pulmonologists and prosthodontists. Disease epidemiology and etiopathology in different patient cohorts is of primary interest in the field of dental sleep medicine.…”

Depression, obstructive sleep apnea and psychosocial health

“…Adherence to the CPAP therapy can offer significant results and improve a patient's psychosocial health. 84 In OSA patients, cognitive symptoms especially mood symptoms greatly improve after treatment with CPAP therapy. 13 In OSA patients, treatment adherence is very important.…”

Effect of the CPAP-SAVER Intervention on Adherence Among Adults with Newly Diagnosed Obstructive Sleep Apnea

“…These factors were usually studied as predictors of CPAP adherence (Budhiraja et al, 2007;Poulet et al, 2009;Ye et al, 2012). In state of the science reviews conducted by Saunamaki and Jehkonen (2007) and more recently by the author (Shapiro, 2014), anxiety was found to be common among those with OSA. OSA symptoms have been shown to be predictors of anxiety in a population-based sample (Shapiro, Culp, & Chertok, 2014).…”