Abstract
Patients with comorbid neurotic and anxiety disorders are more receptive of the discomfort accompanying continuous positive airway pressure therapy than average obstructive sleep apnea patients. The purpose of the study was to analyse short-term and long-term continuous positive airway pressure therapy adherence data of patients with obstructive sleep apnea and comorbid anxiety and stress-related dyssomnias, as this group of disorders is expected to rise in the post-covid era. Study retrospectively analysed clinical outcomes of obstructive sleep apnea patients. All subjects with obstructive sleep apnea were diagnosed based on in-lab videopolysomnography, further referred to CPAP titration and were invited for regular follow-up visits. results showed that subjects with comorbid obstructive sleep apnea and anxiety-related disorders used ventilation therapy more hours per day (6,690 hours/day vs. 5,000 hours/day, ****p<0,0001, anxiety (n=19) vs. controls (n=60)). Patients from the anxiety group remained longer in our therapy program (7,086 years vs. 2,905 years, ****p<0,0001) and had markedly better control over their weight, as the body-mass index of the control group increased by +1,065 kg/m2 per year and the body-mass index in the examination group increased only by +0,296 kg/m2 every year. Our data document that obstructive sleep apnea patients on ventilation therapy, who do not have enough control over their increasing body weight might highly benefit from therapy approaches similar to patients with anxiety-related dyssomnias and that management of obstructive sleep apnea is not an obstacle in concomitant treatment of neurotic and anxiety-related dyssomnias.
Highlights
Recent months of covid-19 pandemic have undisputable impact on our healthcare and economic systems, and, the pandemic impacts prominently our mental health
The results showed that subjects with comorbid obstructive sleep apnea and anxiety-related disorders used ventilation therapy more hours per day (6,690 hours/day vs. 5,000 hours/day, ****p
A part of obstructive sleep apnea (OSA) patients might be falsely diagnosed with insomnia and are sent for OSA screening and consultation at the appropriate time or vice versa, because dyssomnia and insomnia periods might have seasonal character and patients themselves are not able to identify their problem during the routine consultation with their sleep specialists
Summary
Recent months of covid-19 pandemic have undisputable impact on our healthcare and economic systems, and, the pandemic impacts prominently our mental health. The mental health burden of home confinement and imminent concern about social and financial safety impacts unfavorably the lives of communities in pandemic-struck countries. Among all these mentioned facts, we assume a relatively considerable cluster of patients with an increasing ratio of sleep disorders, as the prevalence of dyssomnias during pandemic times and economic crisis typically rises. Other covid-19 specific is the proportion of long-lasting lockdowns and movement restrictions, affecting and changing our lifestyles. Some authors posit that the frequency of anxiety in obstructive sleep apnea patients is higher than in the general population regardless of the gender, or that it is more likely that obstructive sleep apnea patients present with anxiety and depression than the typical symptoms [8]
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