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Central Sleep Apnea Tied to Anxiety
Central Sleep Apnea Tied to Anxiety
ROBERT FINN
Article Outline
• Copyright
SAN FRANCISCO — Patients exhibiting central sleep apnea are three times more likely to have an anxiety disorder than are those with no evidence of central apnea, a study of 314 adults referred to a sleep clinic shows.
There was no association between central sleep apnea (CSA) and depression or between obstructive sleep apnea (OSA) and either anxiety or depression. Dr. Leon Tourian, Jr. of McGill University, Montreal, discussed the findings during a poster session at the annual meeting of the American Psychiatric Association.
In an interview, Dr. Tourian said he found no association between CSA and anxiety to be surprising. “Hyperventilation causes central apnea, because you overshoot your carbon dioxide, and you stop breathing to restore it. And anxiety disorders tend to be very, very sensitive to fluctuations in CO2.”
The subjects had a mean age of 52 years with a range of 16-87 years. Their mean body mass index was 28 kg/m2. They were asked whether they had ever been diagnosed with an anxiety disorder or clinical depression, and 36% said they'd been diagnosed with one or the other.
In all, 66% of the patients had at least one central or obstructive apnea event during the polysomnographic examination. Dr. Tourian said his study examined the relationship between the psychiatric disorders and CSA or OSA events, not formal diagnoses of these sleep disorders.
After adjusting for sleep parameters such as percent of REM sleep, sleep efficiency, and apnea-hypopnea index; demographic covariates such as age, sex, BMI, and caffeine, alcohol, and tobacco consumption; and history of psychiatric and medical disorders, the researchers determined that the odds ratio for anxiety in patients with at least one CSA event was 3.0, which was statistically significant.
Dr. Tourian said other studies have found significant associations between OSA and depression, but these associations are confounded by the fact that OSA is associated with obesity, obesity is associated with metabolic abnormalities, and metabolic abnormalities are associated with depression.
He said he hopes to extend his study, which has now accumulated 639 patients, to be able to specify which anxiety disorders are associated with CSA and which are not. The larger sample size also will allow the researchers to examine the relationship between psychiatric disorders and formally diagnosed CSA or OSA. Dr. Tourian disclosed no conflicts of interest associated with his study.
ROBERT FINN
Article Outline
• Copyright
SAN FRANCISCO — Patients exhibiting central sleep apnea are three times more likely to have an anxiety disorder than are those with no evidence of central apnea, a study of 314 adults referred to a sleep clinic shows.
There was no association between central sleep apnea (CSA) and depression or between obstructive sleep apnea (OSA) and either anxiety or depression. Dr. Leon Tourian, Jr. of McGill University, Montreal, discussed the findings during a poster session at the annual meeting of the American Psychiatric Association.
In an interview, Dr. Tourian said he found no association between CSA and anxiety to be surprising. “Hyperventilation causes central apnea, because you overshoot your carbon dioxide, and you stop breathing to restore it. And anxiety disorders tend to be very, very sensitive to fluctuations in CO2.”
The subjects had a mean age of 52 years with a range of 16-87 years. Their mean body mass index was 28 kg/m2. They were asked whether they had ever been diagnosed with an anxiety disorder or clinical depression, and 36% said they'd been diagnosed with one or the other.
In all, 66% of the patients had at least one central or obstructive apnea event during the polysomnographic examination. Dr. Tourian said his study examined the relationship between the psychiatric disorders and CSA or OSA events, not formal diagnoses of these sleep disorders.
After adjusting for sleep parameters such as percent of REM sleep, sleep efficiency, and apnea-hypopnea index; demographic covariates such as age, sex, BMI, and caffeine, alcohol, and tobacco consumption; and history of psychiatric and medical disorders, the researchers determined that the odds ratio for anxiety in patients with at least one CSA event was 3.0, which was statistically significant.
Dr. Tourian said other studies have found significant associations between OSA and depression, but these associations are confounded by the fact that OSA is associated with obesity, obesity is associated with metabolic abnormalities, and metabolic abnormalities are associated with depression.
He said he hopes to extend his study, which has now accumulated 639 patients, to be able to specify which anxiety disorders are associated with CSA and which are not. The larger sample size also will allow the researchers to examine the relationship between psychiatric disorders and formally diagnosed CSA or OSA. Dr. Tourian disclosed no conflicts of interest associated with his study.
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