Anxiety and Depression in Patients with Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea: the Overlap Syndrome

Overview

Journal Sleep Breath

Publisher Springer

Date 2021 Nov 16

PMID 34783978

Citations 6

Authors

Zhiling Zhao

Dongmei Zhang

Haiyan Sun

Dandan Chang

Xiaoshuang Lv

Junlin Lin

Junqing Liu

Xiaotao Wu

Ke Hu

Xiheng Guo

Zhaohui Tong

Affiliations

Soon will be listed here.

Abstract

Purpose: Psychological symptoms are increasingly being noted in patients with chronic diseases. Currently, little evidence is available on the mental health of patients with overlap syndrome (OVS, chronic obstructive pulmonary disease plus obstructive sleep apnea). This study aimed to describe the prevalence and identify influencing factors of anxiety and depression in patients with OVS.

Methods: We recruited patients admitted for chronic obstructive pulmonary disease (COPD) from July 2018 to July 2019 who also underwent polysomnography tests to assess obstructive sleep apnea (OSA). COPD patients who had an apnea-hypopnea index (AHI) ≥ 5/h were defined as OVS. COPD patients who had an AHI < 5/h were identified as pure COPD. Questionnaires were administered to evaluate depression and anxiety in all subjects. We compared the differences in scores between patients with OVS and pure COPD.

Results: Two hundred and fifty-two patients were included, 180 (71%) patients had OVS, while only 72 patients had pure COPD. In the OVS group, 54% of the patients had depression, and 77% of the patients had anxiety. We found that patients with OVS had higher anxiety (8.00 (4.00, 10.00) vs. 6.00 (3.00, 9.00), p = 0.018) and depression (8.00 (4.00, 10.00) vs. 5.50 (2.25, 10.00), p = 0.022) scores than patients with pure COPD. A higher proportion of patients with hypertension (41% vs. 21%) and coronary heart disease (14% vs. 4%) were found in the OVS group. Chest pain, COPD Assessment Test (CAT) score, and OVS were independent risk factors for depression (P<0.05). A positive correlation was shown between anxiety and depression (r=0.638, p < 0.001).

Conclusions: Anxiety and depression were more severe in patients with OVS than in patients with pure COPD. More attention should be paid to the mental health of OVS patients.

Trial Registration: ClinicalTrials.gov; URL: www.

Clinicaltrials: gov . NO.: NCT03182309. Registered on June 9, 2017; https://clinicaltrials.gov/ct2/show/NCT03182309?term=NCT+03182309&draw=2&rank=1.

Citing Articles

Prevalence and Characteristics of Patients with Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease: Overlap Syndrome.

Fanaridis M, Bouloukaki I, Stathakis G, Steiropoulos P, Tzanakis N, Moniaki V Life (Basel). 2024; 14(5).

PMID: 38792569 PMC: 11122385. DOI: 10.3390/life14050547.

The satisfaction of elderly people with elderly caring social organizations and its relationship with social support and anxiety during the COVID-19 pandemic: a cross-sectional study.

Ding S, Liu G, Xu F, Ji K, Zhao L, Zheng X BMC Public Health. 2023; 23(1):1206.

PMID: 37344834 PMC: 10286353. DOI: 10.1186/s12889-023-15951-x.

Prevalence and effects of sleep-disordered breathing on middle-aged patients with sedative-free generalized anxiety disorder: A prospective case-control study.

Chen T, Kung Y, Lai H, Lee L, Jen I, Chang H Front Psychiatry. 2023; 13:1067437.

PMID: 36699476 PMC: 9869375. DOI: 10.3389/fpsyt.2022.1067437.

The Overlap Syndrome of Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease: A Systematic Review.

Czerwaty K, Dzaman K, Sobczyk K, Sikorska K Biomedicines. 2023; 11(1).

PMID: 36672523 PMC: 9856172. DOI: 10.3390/biomedicines11010016.

Fatigue, Depression, and Anxiety in Patients with COPD, Asthma and Asthma-COPD Overlap.

Hometowska H, Klekowski J, Swiatoniowska-Lonc N, Jankowska-Polanska B, Chabowski M J Clin Med. 2022; 11(24).

PMID: 36556082 PMC: 9785292. DOI: 10.3390/jcm11247466.

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