The association between anxiety and the degree of illness in mild obstructive sleep apnoea.

Introduction Obstructive sleep apnoea (OSA) has been reported to associate with anxiety, but earlier observations are scarce and the role of the persistence of anxiety in this connection is unclear. Objectives To examine the associations between OSA and anxiety, and in particular clarify the observations regarding the role of the persistence of anxiety in this connection. Methods A total of 61 overweight patients with mild OSA participated in a 12-month lifestyle modification study and reported the presence of anxiety both at baseline and on 12-month follow up. They were divided into three groups (no anxiety, n=25; past anxiety, n=13; persistent anxiety, n=23), and the degree of illness was assessed with the apnoea-hypopnea index (AHI). Results The persistence of anxiety was linearly associated with the AHI (P=0.025), which was highest in individuals with persistent anxiety. The likelihood of belonging to the group with persistent anxiety increased 18% for each one-unit increase in the AHI in a model adjusted for age, gender and bodyfat % (odds ratio 1.18, 95% confidence interval 1.031.34, P=0.014). Further adjustments for daytime sleepiness and the effect of participating in the lifestyle modification intervention did not alter this finding. Conclusion Our observations suggest that the persistence of anxiety is independently associated with elevated levels of sleep-disordered breathing and that lifestyle modification interventions with a focus on diet and exercise alone may not be sufficient to treat OSA in individuals with simultaneous persistent anxiety. Please cite this paper as: Lehto SM, Sahlman J, Soini EJ, Gylling H, Vanninen E, Seppa J, Viinamaki H and Tuomilehto H. The association between anxiety and the degree of illness in mild obstructive sleep apnoea. Clin Respir J 2012; 7: 197203.