ABSTRACT
Several studies have investigated the association of obstructive sleep apnea syndrome [OSAS] with depression and anxiety; however, the relationship is still poorly understood. Therefore, we aimed to assess anxious and depressive symptoms in OSA, and evaluate their association with potentially related variables of OSAS. This study included 72 patients newly diagnosed with obstructive sleep apnea and 30 controls. Patients underwent an overnight polysomnography and were assessed using the Epworth sleepiness scale [ESS] for excessive daytime sleepiness [EDS], hospital anxiety and depression scale [HAD] for anxious and depressive symptoms, and Maugeri obstructive sleep apnea syndrome [MOSAS] questionnaire for quality of life [QOL]. 72 OSA patients [60 men and 12 women] whose mean age was 48.8 +/- 11.73 yr and mean apnea and hypopnea index [AHI] was 64 +/- 21.86, were compared with 30 controls according to their HAD scores. We found that the HAD score for anxiety and depression was higher in OSA patients than in the control group [p = 0.001 and 0.002 respectively]. Moreover, the prevalence of symptoms of anxiety in patients with OSA was 33% while that of depression was 51%. Linear regression analysis revealed that daytime sleepiness and reduced QOL were strong predictors of depressive symptoms in OSA patients [P = 0.001 and 0.002 respectively], while reduced QOL was the only predictor of anxious symptoms [p = 0.035]. No significant relations were found between severity of psychological symptoms and AHI or nocturnal hypoxemia in OSA patients. Anxious and depressive symptoms are highly prevalent in patients with moderate to severe untreated OSAS. The severity of depressive symptoms maybe more related to excessive daytime sleepiness than to nocturnal hypoxemia. The reduced QOL is a strong predictor of psychiatric symptoms in OSAS patients. Therefore, patients with OSAS should be routinely screened for psychiatric symptoms to improve QOL and optimize diagnosis and therapy in these patients