Anxiety and Depression Symptoms in Patients with Sleep-Disordered Breathing
Margarita Reyes-Zúñiga 1, Armando Castorena-Maldonado 1, José Luis Carrillo-Alduenda 1, Rogelio Pérez-Padilla 1, 2, Araceli Martínez-Estrada 3, Leonardo Gómez-Torres 4, Luis Torre-Bouscoulet*, 1, 2
1 Sleep Medicine Unit, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas; Mexico City, Mexico
2 Department of Respiratory Physiology, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas; Mexico City, Mexico
3 Universidad La Salle, Faculty of Medicine; Mexico City, Mexico
4 Hospital Italiano de Buenos Aires; Buenos Aires, Argentina
Information concerning the frequency of anxiety and depression symptoms in patients with sleep-disordered breathing (SDB) is controversial. Hence, the objectives of this study were to: determine the frequency of anxiety and depression symptoms in patients with SDB; explore whether the frequency of anxiety and depression symptoms rises with increasing parameters of SDB severity; and investigate the factors potentially associated with anxiety and depression.
Materials and Methodology:
Data was collected from consecutive adult patients referred to the National Institute of Respiratory Diseases’ Sleep Medicine Unit from October 2008 to October 2009. SDB diagnoses were established using standard polysomnography or simplified respiratory polygraphy. All patients routinely completed the Hospital Anxiety and Depression Scale (HADS) on their first visit to the Sleep Medicine Unit.
382 patients with SDB were included. Mean age was 50.8±13.6 years, 62% were male. Anxiety symptoms were acknowledged by 71 patients (18.5%), while 29 (7.6%) had depression symptoms, and 116 (30.4%) had symptoms of anxiety plus depression. Patients who reported anxiety and depression symptoms scored higher on the Epworth Sleepiness Scale (ESS, 16±7) than those with no symptoms (11±6) (p<0.0001). Patients with symptoms of anxiety plus depression also had higher BMIs (36 ± 8 K/m2) than patients with SDB without anxiety or depression. No other differences were observed, not even with respect to the parameters of the severity of their SDB.
Our results support the recommendation that due to their high frequency and potential importance for long-term adherence to CPAP, anxiety and depression symptoms should be included in the routine evaluation of all adults with SDB.
open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
* Address correspondence to this author at the Department of Respiratory Physiology and Sleep Medicine Unit, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas; Mexico City, Mexico; Tlalpan 4502, Colonia Sección XVI, Delegación Tlalpan CP 14080, D.F., México; Tel/Fax: (52) (55) 5665-4748; E-mail: email@example.com