Sleep quality and mental health during the COVID-19 pandemic in patients with severe obstructive sleep apnea.
Anxiety
COVID-19
CPAP
Coronavirus Anxiety Scale
Depression
Obstructive sleep apnea
PSQI
Sleep quality
Journal
Journal of patient-reported outcomes
ISSN: 2509-8020
Titre abrégé: J Patient Rep Outcomes
Pays: Germany
ID NLM: 101722688
Informations de publication
Date de publication:
08 May 2022
08 May 2022
Historique:
received:
11
01
2022
accepted:
27
04
2022
entrez:
8
5
2022
pubmed:
9
5
2022
medline:
9
5
2022
Statut:
epublish
Résumé
The first wave of the COVID-19 pandemic has produced remarkable effects on the sleep quality and mental status of the general population and more dramatic effects on patients with chronic illness. Patients with obstructive sleep apnea (OSA), already suffering from disordered sleep, might be more susceptible to the effect of the pandemic on their sleep quality and mental health. We therefore performed a case-control study to compare sleep quality, depression and anxiety symptoms reported by patients with severe OSA and age-matched healthy subjects during the first wave of the COVID-19. In June-July 2020 we enrolled a total of 222 patients with severe OSA, all treated with continuous positive airway pressure, and 164 healthy controls. Self-reported sleep quality was assessed using the Pittsburg Sleep Quality Index (PSQI). Symptoms of depression were assessed using the Patient Health Questionnaire module 9 (PHQ-9), while the specific "Coronavirus Anxiety Scale" (CAS) evaluated the level of anxiety. Patients with OSA (61% males, 65 ± 9.6 years old, BMI 30.5 ± 3.6) and healthy controls had similar characteristics except for BMI slightly lower in controls. The perceived quality of sleep, referred to the pre-pandemic period, was significantly worse in patients with OSA than in controls. During the pandemic the rate of reported sleep disturbance increased from 54 to 66% in patients with OSA and from 29 to 40% in controls. A high percentage of patients and controls reported symptoms of depression (61% OSA and 65% controls), whereas lower levels of anxiety, similar in the two groups, were observed. In patients with OSA the PSQI score significantly positively correlated with the PHQ-9 score (r The rate of reported sleep disturbance in patients with OSA during the first wave of the COVID-19 pandemic is one of the highest evidenced in literature so far. As for the general population, in these patients there is a strict link between the perceived sleep quality and the psychological distress caused by the pandemic. A further deterioration of sleep quality is a fearsome event in the life of these patients who face life-long sleep problems.
Sections du résumé
BACKGROUND
BACKGROUND
The first wave of the COVID-19 pandemic has produced remarkable effects on the sleep quality and mental status of the general population and more dramatic effects on patients with chronic illness. Patients with obstructive sleep apnea (OSA), already suffering from disordered sleep, might be more susceptible to the effect of the pandemic on their sleep quality and mental health. We therefore performed a case-control study to compare sleep quality, depression and anxiety symptoms reported by patients with severe OSA and age-matched healthy subjects during the first wave of the COVID-19. In June-July 2020 we enrolled a total of 222 patients with severe OSA, all treated with continuous positive airway pressure, and 164 healthy controls. Self-reported sleep quality was assessed using the Pittsburg Sleep Quality Index (PSQI). Symptoms of depression were assessed using the Patient Health Questionnaire module 9 (PHQ-9), while the specific "Coronavirus Anxiety Scale" (CAS) evaluated the level of anxiety.
RESULTS
RESULTS
Patients with OSA (61% males, 65 ± 9.6 years old, BMI 30.5 ± 3.6) and healthy controls had similar characteristics except for BMI slightly lower in controls. The perceived quality of sleep, referred to the pre-pandemic period, was significantly worse in patients with OSA than in controls. During the pandemic the rate of reported sleep disturbance increased from 54 to 66% in patients with OSA and from 29 to 40% in controls. A high percentage of patients and controls reported symptoms of depression (61% OSA and 65% controls), whereas lower levels of anxiety, similar in the two groups, were observed. In patients with OSA the PSQI score significantly positively correlated with the PHQ-9 score (r
CONCLUSION
CONCLUSIONS
The rate of reported sleep disturbance in patients with OSA during the first wave of the COVID-19 pandemic is one of the highest evidenced in literature so far. As for the general population, in these patients there is a strict link between the perceived sleep quality and the psychological distress caused by the pandemic. A further deterioration of sleep quality is a fearsome event in the life of these patients who face life-long sleep problems.
Identifiants
pubmed: 35526189
doi: 10.1186/s41687-022-00454-x
pii: 10.1186/s41687-022-00454-x
pmc: PMC9079209
doi:
Types de publication
Journal Article
Langues
eng
Pagination
46Informations de copyright
© 2022. The Author(s).
Références
WHO (2020) Mental health and psychosocial considerations during COVID-19 outbreak. https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf
Trakada A, Nikolaidis PT, Andrade M, Puccinelli PJ, Economou NT, Steiropoulos P et al (2020) Sleep during “lockdown” in the COVID-19 pandemic. Int J Environ Res Public Health 17:9094. https://doi.org/10.3390/ijerph17239094
doi: 10.3390/ijerph17239094
pmcid: 7729605
Jahrami H, BaHammam AS, Bragazzi NL, Saif Z, Faris M, Vitiello MV (2021) Sleep problems during the COVID-19 pandemic by population: a systematic review and meta-analysis. J Clin Sleep Med 17:299–313. https://doi.org/10.5664/jcsm.8930
doi: 10.5664/jcsm.8930
pubmed: 33108269
pmcid: 7853219
Spicuzza L (2020) Sleep disturbance and COVID-19 an epidemic inside the pandemic. Infect Dis Ther 2(1):1–1
Zhang F, Shang Z, Ma H, Jia Y, Sun L, Guo X et al (2020) Epidemic area contact history and sleep quality associated with posttraumatic stress symptoms in the first phase of COVID-19 outbreak in China. Sci Rep 10:22463. https://doi.org/10.1038/s41598-020-80649-8
doi: 10.1038/s41598-020-80649-8
pubmed: 33384438
pmcid: 7775460
Casagrande M, Favieri F, Tambelli R, Forte G (2020) The enemy who sealed the world: effects quarantine due to the COVID-19 on sleep quality, anxiety, and psychological distress in the Italian population. Sleep Med 75:12–20. https://doi.org/10.1016/j.sleep.2020.05.011
doi: 10.1016/j.sleep.2020.05.011
pubmed: 32853913
pmcid: 7215153
van Mill JG, Hoogendijk WJ, Vogelzangs N, van Dyck R, Penninx BW (2010) Insomnia and sleep duration in a large cohort of patients with major depressive disorder and anxiety disorders. J Clin Psychiatry 71:239–246. https://doi.org/10.4088/JCP.09m05218gry
doi: 10.4088/JCP.09m05218gry
pubmed: 20331928
Killgore W, Cloonan SA, Taylor EC, Fernandez F, Grandner MA, Dailey NS (2020) Suicidal ideation during the COVID-19 pandemic. The role of insomnia. Psychiatry Res 290:113134. https://doi.org/10.1016/j.psychres.2020.113134
doi: 10.1016/j.psychres.2020.113134
pubmed: 32505030
pmcid: 7255187
Lebrasseur A, Fortin-Bédard N, Lettre J, Raymond E, Bussières EL, Lapierre N (2021) Impact of the COVID-19 pandemic on older adults: rapid review. JMIR Aging 4(2):e26474. https://doi.org/10.2196/26474
doi: 10.2196/26474
pubmed: 33720839
pmcid: 8043147
Spicuzza L, Caruso D, Di Maria G (2015) Obstructive sleep apnoea syndrome and its management. Ther Adv Chronic Dis 6:273–285. https://doi.org/10.1177/2040622315590318
doi: 10.1177/2040622315590318
pubmed: 26336596
pmcid: 4549693
Kaufmann CN, Susukida R, Depp CA (2017) Sleep apnea, psychopathology, and mental health care. Sleep Health 3:244–249. https://doi.org/10.1016/j.sleh.2017.04.003
doi: 10.1016/j.sleh.2017.04.003
pubmed: 28709510
pmcid: 5560422
Buysse DJ, Reynolds CF 3rd, Monk TH, Hoch CC, Yeager AL, Kupfer DJ (1991) Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep 14:331–338
pubmed: 1947597
Curcio G, Tempesta D, Scarlata S, Marzano C, Moroni F, Rossini PM et al (2013) Validity of the Italian version of the Pittsburgh Sleep Quality Index (PSQI). Neurol Sci 34:511–519. https://doi.org/10.1007/s10072-012-1085-y
doi: 10.1007/s10072-012-1085-y
pubmed: 22526760
Lee SA (2020) Coronavirus Anxiety Scale: a brief mental health screener for COVID-19 related anxiety. Death Stud 44:393–401. https://doi.org/10.1080/07481187.2020.1748481
doi: 10.1080/07481187.2020.1748481
pubmed: 32299304
Lee SA, Mathis AA, Jobe MC, Pappalardo EA (2020) Clinically significant fear and anxiety of COVID-19: a psychometric examination of the Coronavirus Anxiety Scale. Psychiatry Res 290:113112. https://doi.org/10.1016/j.psychres.2020.113112
doi: 10.1016/j.psychres.2020.113112
pubmed: 32460185
pmcid: 7237368
Soraci P, Ferrari A, Abbiati FA, Del Fante E, De Pace R, Urso A et al (2020) Validation and psychometric evaluation of the Italian version of the fear of COVID-19 scale. Int J Ment Health Addict. https://doi.org/10.1007/s11469-020-00277-1
doi: 10.1007/s11469-020-00277-1
pubmed: 32372892
pmcid: 7198091
Berg LM, Ankjell T, Sun YQ, Trovik TA, Rikardsen OG, Sjögren A et al (2020) Health-related quality of life and sleep quality after 12 months of treatment in nonsevere obstructive sleep apnea: a randomized clinical trial with continuous positive airway pressure and mandibular advancement splints. Int J Otolaryngol 28:56460. https://doi.org/10.1155/2020/2856460
doi: 10.1155/2020/2856460
Mathiasen K, Andersen TE, Riper H, Kleiboer AA, Roessler KK (2016) Blended CBT versus face-to-face CBT: a randomised non-inferiority trial. BMC Psychiatry 16(1):432
doi: 10.1186/s12888-016-1140-y
Kroenke K, Spitzer RL (2002) The PHQ-9: a new depression diagnostic and severity measure. Psychiatr Ann 32(9):1–7
doi: 10.3928/0048-5713-20020901-06
Lee PH, Marek J, Nálevka P (2021) Sleep pattern in the US and 16 European countries during the COVID-19 outbreak using crowdsourced smartphone data. Eur J Pub Health 31:23–30. https://doi.org/10.1093/eurpub/ckaa208
doi: 10.1093/eurpub/ckaa208
Blume C, Schmidt MH, Cajochen C (2020) Effects of the COVID-19 lockdown on human sleep and rest-activity rhythms. Curr Biol 30:795–797. https://doi.org/10.1016/j.cub.2020.06.021
doi: 10.1016/j.cub.2020.06.021
Cellini N, Canale N, Mioni G, Costa S (2020) Changes in sleep pattern, sense of time and digital media use during COVID-19 lockdown in Italy. J Sleep Res 29:13074. https://doi.org/10.1111/jsr.13074
doi: 10.1111/jsr.13074
Pépin JL, Sauvaget O, Borel JC, Rolland C, Sapéne M, Amroussia I et al (2020) Continuous positive airway pressure-treated patients’ behaviours during the COVID-19 crisis. ERJ Open Res. https://doi.org/10.1183/23120541.00508-2020
doi: 10.1183/23120541.00508-2020
pubmed: 33257912
pmcid: 7520943
de Barros Phys JL, Rodrigues WC, Marão AC, de Oliveira Antunes LC, Trindade SHK, Weber SAT (2021) Impact of CPAP treatment for a short period in moderate-to-severe OSAS patients: a randomized double-blind clinical trial. Braz J Otorhinolaryngol. https://doi.org/10.1016/j.bjorl.2020.12.011
doi: 10.1016/j.bjorl.2020.12.011
pubmed: 33563569
McArdle N, Douglas NJ (2001) Effect of continuous positive airway pressure on sleep architecture in the sleep apnea-hypopnea syndrome: a randomized controlled trial. Am J Respir Crit Care Med 164:1459–1463. https://doi.org/10.1164/ajrccm.164.8.2008146
doi: 10.1164/ajrccm.164.8.2008146
pubmed: 11704596
Steptoe A, Di Gessa G (2021) Mental health and social interactions of older people with physical disabilities in England during the COVID-19 pandemic: a longitudinal cohort study. Lancet Public Health 6:365–373. https://doi.org/10.1016/S2468-2667(21)00069-4
doi: 10.1016/S2468-2667(21)00069-4
Lima MG, Malta DC, Werneck AO, Szwarcwald CL, Souza DB, Gomes CS et al (2021) Effect of chronic non-communicable diseases (CNCDs) on the sleep of Brazilians during the COVID-19 pandemic. Sleep Med. https://doi.org/10.1016/j.sleep.2021.02.052
doi: 10.1016/j.sleep.2021.02.052
pubmed: 33736945
pmcid: 9017860
Louvardi M, Pelekasis P, Chrousos GP, Darviri C (2020) Mental health in chronic disease patients during the COVID-19 quarantine in Greece. Palliat Support Care 18:394–399. https://doi.org/10.1017/S1478951520000528
doi: 10.1017/S1478951520000528
pubmed: 32594950
Chung F, Waseem R, Pham C, Penzel T, Han F, Bjorvatn B, International COVID Sleep Study (ICOSS) group et al (2021) The association between high risk of sleep apnea, comorbidities, and risk of COVID-19: a population-based international harmonized study. Sleep Breath Schlaf Atmung 25:849–860. https://doi.org/10.1007/s11325-021-02373-5
doi: 10.1007/s11325-021-02373-5
pubmed: 33907966