Self-reported health outcomes in patients with obstructive sleep apnoea: Unraveling the role of bio-psycho-social factors

Abstract

Obstructive sleep apnoea (OSA) is a heterogeneous and complex disease; it‘s management, however, is still based on limited effective treatment options. The aim of this thesis was to examine the bio-psycho-social factors that have been identified as key determinants in the adaptation to various chronic diseases, but evidence in OSA is lacking. The acquired knowledge further contributes to a better understanding of the associations between bio-psycho-social factors and selected self-reported health outcomes in OSA patients, i.e. quality of life, functional status, work functioning, and psychological distress — with particular interest in suicidal ideation. The results of our meta-analysis confirmed that continuous positive airway pressure treatment may help to improve physical OSA symptoms, whereas the existing psychological impairment cannot be alleviated. Our study revealed a high prevalence of psychological distress in OSA patients, among others suicidal ideation and anxiety. Thus, the necessity of monitoring psychological symptoms in OSA during clinical care should be highlighted. Another finding was that external resources, such as social support or coping self-efficacy for the ability to get support, explained less variance in health outcomes when compared to intra-individual resources, such as personal mastery, problem focused coping self-efficacy, or the ability to stop unpleasant emotions and thoughts. Therefore, encouraging mastery and dispelling adequate coping self-efficacy may be paramount in improving functional status and addressing psychological distress in OSA. Finally, the obtained knowledge may help to facilitate recommendations for current clinical practice and research related to OSA management and treatment as dictated by the complex needs of patients.