The Impact of Depression, Anxiety on CPAP Adherence
SEATTLE, WA—Depression and anxiety do not appear to influence continuous positive airway pressure (CPAP) compliance in adults with obstructive sleep apnea (OSA), reported V.V.S. Ramesh Metta, MBBS, of the VA Western Healthcare System, Buffalo, NY.
Close to 17% of patients with OSA suffer from depression or anxiety but “there is sparse data regarding impact of behavioral factors on CPAP adherence,” noted Dr. Mettta at SLEEP 2015. The research team reported findings of a case-control retrospective analysis of three-month and one-year adherence rates with CPAP therapy in a predominantly male, Caucasian group of sleep apnea patients with depression and anxiety, compared with controls. Patients were matched for severity of sleep apnea (AHI), body mass index (BMI), and age at time of diagnosis.
Mean AHI among patients in the depression group (n=246) was 37.6±26.2 vs. 36.6±28.7 (P=0.86) in the control group; and mean BMI was 35.1±6.7 vs. 35.3±6.2 (P=0.80). In the anxiety group (n=166), mean AHI among cases and controls was 29±22 and 29.9±23.8 (P=0.80); and mean BMI was 34.1±6.2 and 34.4±6.1 (P=0.75).
There was no statistically significant difference in PAP use between depressed patients and controls at 3 months (percent days device use >4 hours, 52.9±33.7 vs. 48.5±35.8, P=0.40) and 1 year (percent days device use >4 hours, 62.5±36.2 vs. 65.1±29.4, P=0.60) visits respectively.
Patients with anxiety had similar adherence rates compared to controls at three months (percent days device use >4 hours, 51.2± 35 vs. 43.8±33.6 P=0.23) and at one year (percent days device use >4 hours, 61.6±33.9 vs. 57±34.8, P=0.49) visits, respectively.
“CPAP adherence is not significantly different among patients with anxiety and depression on active medical therapy, compared to matched controls,” Dr. Metta concluded.