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16.11.2021 | Sleep Breathing Physiology and Disorders • Original Article

Anxiety and depression in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome

verfasst von: Zhiling Zhao, Dongmei Zhang, Haiyan Sun, Dandan Chang, Xiaoshuang Lv, Junlin Lin, Junqing Liu, Xiaotao Wu, Ke Hu, Xiheng Guo, Zhaohui Tong

Erschienen in: Sleep and Breathing | Ausgabe 4/2022

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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.: NCT 03182309. Registered on June 9, 2017; https://clinicaltrials.gov/ct2/show/NCT03182309?term=NCT+03182309&draw=2&rank=1

James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N et al (2018) Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392(10159):1789–1858. https://doi.org/10.1016/S0140-6736(18)32279-7CrossRef

Wang C, Xu J, Yang L, Xu Y, Zhang X, Bai C et al (2018) Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet (London, England) 391(10131):1706–1717. https://doi.org/10.1016/S0140-6736(18)30841-9CrossRef

Nanthakumar S, Bucks RS, Skinner TC, Starkstein S, Hillman D, James A et al (2017) Assessment of the Depression, Anxiety, and Stress Scale (DASS-21) in untreated obstructive sleep apnea (OSA). Psychol Assess 29(10):1201–1209. https://doi.org/10.1037/pas0000401CrossRefPubMed

Economou N-T, Ilias I, Velentza L, Papachatzakis Y, Zarogoulidis P, Kallianos A et al (2018) Sleepiness, fatigue, anxiety and depression in Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea - Overlap - Syndrome, before and after continuous positive airways pressure therapy. PLoS One 13(6):e0197342. https://doi.org/10.1371/journal.pone.0197342CrossRefPubMedPubMedCentral

Global Initiative for Chronic Obstructive Lung Disease (GOLD) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease 2020 report wwwgoldcopdorg.

Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K et al (2017) Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med 13(3):479–504. https://doi.org/10.5664/jcsm.6506CrossRefPubMedPubMedCentral

Jones PW, Harding G, Berry P, Wiklund I, Chen WH, Kline Leidy N (2009) Development and first validation of the COPD Assessment Test. Eur Respir J 34(3):648–654. https://doi.org/10.1183/09031936.00102509CrossRefPubMed

Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.xCrossRefPubMed

Papachatzakis I, Velentza L, Zarogoulidis P, Kallianos A, Trakada G (2018) Comorbidities in coexisting chronic obstructive pulmonary disease and obstructive sleep apnea - overlap syndrome. Eur Rev Med Pharmacol Sci 22(13):4325–4331. https://doi.org/10.26355/eurrev_201807_15429CrossRefPubMed

10.

Hanania NA, Mullerova H, Locantore NW, Vestbo J, Watkins ML, Wouters EF et al (2011) Determinants of depression in the ECLIPSE chronic obstructive pulmonary disease cohort. Am J Respir Crit Care Med 183(5):604–611. https://doi.org/10.1164/rccm.201003-0472OCCrossRefPubMed

11.

Yohannes AM, Willgoss TG, Baldwin RC, Connolly MJ (2010) Depression and anxiety in chronic heart failure and chronic obstructive pulmonary disease: prevalence, relevance, clinical implications and management principles. International Journal of Geriatric Psychiatry 25(12):1209–1221. https://doi.org/10.1002/gps.2463CrossRefPubMed

12.

Shapiro AL, Culp S, Azulay Chertok IR (2014) OSA symptoms associated with and predictive of anxiety in middle-aged men: secondary analysis of NHANES data. Arch Psychiatr Nurs 28(3):200–205. https://doi.org/10.1016/j.apnu.2014.02.002CrossRefPubMed

13.

Chen YH, Keller JK, Kang JH, Hsieh HJ, Lin HC (2013) Obstructive sleep apnea and the subsequent risk of depressive disorder: a population-based follow-up study. J Clin Sleep Med 9(5):417–423. https://doi.org/10.5664/jcsm.2652CrossRefPubMedPubMedCentral

14.

Ejaz SM, Khawaja IS, Bhatia S, Hurwitz TD (2011) Obstructive sleep apnea and depression: a review. Innov Clin Neurosci 8(8):17–25PubMedPubMedCentral

15.

Underner M, Cuvelier A, Peiffer G, Perriot J, Jaafari N (2018) The influence of anxiety and depression on COPD exacerbations. Rev Mal Respir 35(6):604–625. https://doi.org/10.1016/j.rmr.2018.04.004CrossRefPubMed

16.

Yohannes AM, Mulerova H, Lavoie K, Vestbo J, Rennard SI, Wouters E et al (2017) The association of depressive symptoms with rates of acute exacerbations in patients with COPD: results from a 3-year longitudinal follow-up of the ECLIPSE cohort. J Am Med Dir Assoc 18(1):955-959.e6. https://doi.org/10.1016/j.jamda.2017.05.024CrossRefPubMed

17.

Huang J, Bian Y, Zhao Y, Jin Z, Liu L, Li G (2021) The impact of depression and anxiety on chronic obstructive pulmonary disease acute exacerbations: a prospective cohort study. Journal of Affective Disorders 281:147–152. https://doi.org/10.1016/j.jad.2020.12.030CrossRefPubMed

18.

Bordoni B, Marelli F, Morabito B, Sacconi B (2017) Depression, anxiety and chronic pain in patients with chronic obstructive pulmonary disease: the influence of breath. Monaldi Arch Chest Dis 87(1):811. https://doi.org/10.4081/monaldi.2017.811CrossRefPubMed

19.

Lee AL, Goldstein RS, Brooks D (2017) Chronic pain in people with chronic obstructive pulmonary disease: prevalence, clinical and psychological implications. Chronic Obstr Pulm Dis 4(3):194–203. https://doi.org/10.15326/jcopdf.4.3.2016.0172CrossRefPubMedPubMedCentral

20.

Miravitlles M, Molina J, Quintano JA, Campuzano A, Pérez J, Roncero C (2014) Factors associated with depression and severe depression in patients with COPD. Respir Med 108(11):1615–1625. https://doi.org/10.1016/j.rmed.2014.08.010CrossRefPubMed

21.

Silva JJL, Conde MB, de Sousa Corrêa K, da SC, da SPL, Rabahi MF, (2014) COPD Assessment Test (CAT) score as a predictor of major depression among subjects with chronic obstructive pulmonary disease and mild hypoxemia: a case-control study. BMC Pulm Med 14:186. https://doi.org/10.1186/1471-2466-14-186CrossRefPubMedPubMedCentral

22.

Gupta MA, Knapp K (2014) Cardiovascular and psychiatric morbidity in obstructive sleep apnea (OSA) with insomnia (sleep apnea plus) versus obstructive sleep apnea without insomnia: a case-control study from a Nationally Representative US sample. PLoS One 9(3):e90021. https://doi.org/10.1371/journal.pone.0090021CrossRefPubMedPubMedCentral

23.

Hu W, Zhao Z, Wu B, Shi Z, Dong M, Xiong M et al (2020) Obstructive sleep apnea increases the prevalence of hypertension in patients with chronic obstructive disease. COPD 17(5):523–532. https://doi.org/10.1080/15412555.2020.1815688CrossRefPubMed

Titel: Anxiety and depression in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome
verfasst von: Zhiling Zhao
Dongmei Zhang
Haiyan Sun
Dandan Chang
Xiaoshuang Lv
Junlin Lin
Junqing Liu
Xiaotao Wu
Ke Hu
Xiheng Guo
Zhaohui Tong
Publikationsdatum: 16.11.2021
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 4/2022
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-021-02500-2

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Anxiety and depression in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome