Emotional states and quality of life in patients with obstructive sleep apnea

The aim of this study was to assess the substantial impact of obstructive sleep apnea (OSA) on emotional states and quality of life (QOL) along with the effect of treatment with continuous positive airway pressure (CPAP). Patients with any psychiatric disorders and serious physical diseases were excluded from the study. Thirty-one OSA patients and 63 healthy controls were asked to complete Profile of Mood States (POMS) and QOL-26 questionnaires at the commencement of the study, and then again after 3 months of CPAP treatment. The OSA group scored significantly higher (worse) in five mood factors and significantly lower (worse) in four QOL domains than the control group. Continuous positive airway pressure treatment produced significant improvement in the majority of emotional states and QOL after 3 months. These findings suggest that sleep apnea is at least partially responsible for emotional changes and reducing QOL. Furthermore, we found significant correlations between the apnea-hypopnea index (AHI) and tension-anxiety as well as fatigue-inertia and the physical QOL domain after 3 months of CPAP treatment. Some OSA patients had residual sleep apnea in spite of CPAP treatment due to severe obesity and tonsillar hypertrophy, and their mood states and QOL did not improve. Thus residual sleep apnea may impede improvement in emotional states and QOL in OSA patients. We believe that the frequency of apnea and hypopnea during sleep needs to be brought as close as possible to zero with intensive and combined therapy to improve emotional states and QOL in OSA patients. © 2005 Japanese Society of Sleep Research.