Obstructive sleep apnea risk and psychological health among non-Hispanic blacks in the Metabolic Syndrome Outcome (MetSO) cohort study

Abstract

Introduction This study assessed associations of depression and anxiety with risk of OSA among Non-Hispanic Blacks in the Metabolic Syndrome Outcome (MetSO) study. Method 1,035 patients provided data for the analysis. ARES™ score ≥ 6 defined high OSA risk. Moderate depression was defined by a CES-D score ≥ 16. Moderate anxiety was measured by a BAI score ≥ 16. Results The mean age was 62 ± 14 years; 70% were female. 93% were diagnosed with hypertension; 61%, diabetes; and 72%, dyslipidemia; 90% were overweight/obese; 33% had a history of heart disease and 10% had a stroke. Logistic regression analysis, adjusting for age and gender, showed that patients with depression had nearly a two-fold increased odds of being at risk for OSA (OR = 1.75, 95% CI = 1.02–2.98, p < .05). Patients with anxiety had a three-fold increased odds of being at risk for OSA (OR = 3.30, 95% CI = 2.11–5.15, p < .01). After adjusting for marital status and income, patients with anxiety had a 6% increase in OSA risk (OR=1.06, 95% CI= 1.04–1.09, p<.05) but depression was no longer significant. Conclusion Our results suggest that Non-Hispanic Blacks with metabolic syndrome who experience anxiety and/or depression should be screened for OSA.

The relationships between obstructive sleep apnea and psychiatric disorders: a narrative review

“…Psychotic disorders and bipolar disorders connections with sleep apnea are confirmed, but it is not yet well understood [15,63]. All correlations are found to be possibly bidirectional [19,24,26,38,40,47] Psychiatric disorders and OSA have a negative effect on the central nervous system [80]. Increased activity of the sympathetic nervous system is found by OSA which can increase anxiety symptoms [5].…”

“…The link between anxiety and OSA has been found by several studies [15,23,24,38]. The prevalence of anxiety symptoms in OSA changes depending on studies and was assumed to range from 11% to 70% [39] with the mean of 32% [40], as for present OSA in anxiety disorder it is suggested to be between 6.4% [19] and 57.1% [15].…”

“…The prevalence of anxiety symptoms in OSA changes depending on studies and was assumed to range from 11% to 70% [39] with the mean of 32% [40], as for present OSA in anxiety disorder it is suggested to be between 6.4% [19] and 57.1% [15]. The connection was found to be bidirectional as Kaufmann et al (2017) estimated that OSA increases 3.68 times probability of anxiety [24] and Ceide et al (2015) founded that patients with moderate to severe anxiety had a 3.30 higher risk of OSA [38]. A few long-term studies showed that CPAP has a positive effect on both disorders [39].…”

Sleep Characteristics in Adults of African Descent at Risk for and with Cardiometabolic Conditions: A Systematic Review

“…Sleep disorders were determined by assessing snoring, sleep-disordered breathing, obstructive sleep apnea, and insomnia in 10 studies [32,[34][35][36]45,48,51,[62][63][64]. In four studies, home sleep apnea testing devices such as ARES ® were used [36,48,51,65], and two studies used polysomnography [32,37]. Objective sleep measures, including >15 apnea events per hour and percent sleep with less than 90% oxygen saturation, were reported in 6 studies.…”

Differences in short and long sleep durations between blacks and whites attributed to emotional distress: analysis of the National Health Interview Survey in the United States

“…1–4 Evidence shows that unhealthy sleep duration is more prevalent among blacks compared with whites 5 and has been linked to increased cardiovascular and cerebrovascular risk, metabolic disorders, and diminished mental health functioning. 6,7 While the negative health consequences of unhealthy sleep are well-documented, there are limited data on potential determinants of unhealthy sleep duration, especially among blacks in the U.S. who have a higher prevalence of short and long sleep duration compared to whites. 1 Differences in sleep duration between blacks and whites have been attributed to: a) biological factors 8,9 b) behavioral factors 10 ; c) environmental factors 11,12 ; d) psychosocial factors 13–15 ; and e) medical conditions 16,17 .…”