Depressive, anxiety, and sleep disturbance symptoms in patients with obstructive sleep apnea: a network analysis perspective

Abstract Background Patients with obstructive sleep apnea (OSA) frequently experience sleep disturbance and psychological distress, such as depression and anxiety, which may have a negative impact on their health status and functional abilities. To gain a more comprehensive understanding of the symp...

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Main Authors: Xue Luo, Shuangyan Li, Qianyun Wu, Yan Xu, Ruichen Fang, Yihong Cheng, Bin Zhang
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Psychiatry
Subjects:
Online Access:https://doi.org/10.1186/s12888-025-06532-w
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author Xue Luo
Shuangyan Li
Qianyun Wu
Yan Xu
Ruichen Fang
Yihong Cheng
Bin Zhang
author_facet Xue Luo
Shuangyan Li
Qianyun Wu
Yan Xu
Ruichen Fang
Yihong Cheng
Bin Zhang
author_sort Xue Luo
collection DOAJ
description Abstract Background Patients with obstructive sleep apnea (OSA) frequently experience sleep disturbance and psychological distress, such as depression and anxiety, which may have a negative impact on their health status and functional abilities. To gain a more comprehensive understanding of the symptoms of depression, anxiety, and sleep disturbance in patients with OSA, the current study utilized network analysis to examine the interconnections among these symptoms. Methods Depressive and anxiety symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS), and sleep disturbance symptoms were evaluated using the Pittsburgh Sleep Quality Index (PSQI). A total of 621 patients with OSA completed the questionnaires. The indices 'Expected influence' and 'Bridge expected influence' were used as centrality measures in the symptom network. The Least Absolute Shrinkage and Selection Operator (LASSO) technique and the Extended Bayesian Information Criterion (EBIC) were utilized to estimate the network structure of depressive, anxiety, and sleep disturbance symptoms. A Network Comparison Test (NCT) was performed to evaluate the differences between the mild to moderate OSA and severe OSA networks. Results Network analysis revealed that A6 (“Getting sudden feelings of panic”) had the highest expected influence value and D6 (“Feeling being slowed down”) had the highest bridge expected influence values in the networks. The NCT results revealed that the edge weights significantly differed between patients with mild to moderate OSA and those with severe OSA (M = 0.263, p = 0.008). There was no significant difference in global strength variation between the two networks (S = 0.185, p = 0.773). Conclusions Our results suggest that the highest expected influence value and bridge symptoms (e.g., A6 and D6) can be prioritized as potential targets for intervention and treatment in patients with OSA.
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spelling doaj-art-7ab840929f1a4127ac6864cf0c5fd4a32025-02-02T12:36:02ZengBMCBMC Psychiatry1471-244X2025-01-0125111210.1186/s12888-025-06532-wDepressive, anxiety, and sleep disturbance symptoms in patients with obstructive sleep apnea: a network analysis perspectiveXue Luo0Shuangyan Li1Qianyun Wu2Yan Xu3Ruichen Fang4Yihong Cheng5Bin Zhang6Department of Psychiatry Sleep Medical Center, Nanfang Hospital Southern Medical UniversityDepartment of Psychiatry Sleep Medical Center, Nanfang Hospital Southern Medical UniversityDepartment of Psychiatry Sleep Medical Center, Nanfang Hospital Southern Medical UniversityDepartment of Psychiatry Sleep Medical Center, Nanfang Hospital Southern Medical UniversityDepartment of Psychiatry Sleep Medical Center, Nanfang Hospital Southern Medical UniversityDepartment of Psychiatry Sleep Medical Center, Nanfang Hospital Southern Medical UniversityDepartment of Psychiatry Sleep Medical Center, Nanfang Hospital Southern Medical UniversityAbstract Background Patients with obstructive sleep apnea (OSA) frequently experience sleep disturbance and psychological distress, such as depression and anxiety, which may have a negative impact on their health status and functional abilities. To gain a more comprehensive understanding of the symptoms of depression, anxiety, and sleep disturbance in patients with OSA, the current study utilized network analysis to examine the interconnections among these symptoms. Methods Depressive and anxiety symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS), and sleep disturbance symptoms were evaluated using the Pittsburgh Sleep Quality Index (PSQI). A total of 621 patients with OSA completed the questionnaires. The indices 'Expected influence' and 'Bridge expected influence' were used as centrality measures in the symptom network. The Least Absolute Shrinkage and Selection Operator (LASSO) technique and the Extended Bayesian Information Criterion (EBIC) were utilized to estimate the network structure of depressive, anxiety, and sleep disturbance symptoms. A Network Comparison Test (NCT) was performed to evaluate the differences between the mild to moderate OSA and severe OSA networks. Results Network analysis revealed that A6 (“Getting sudden feelings of panic”) had the highest expected influence value and D6 (“Feeling being slowed down”) had the highest bridge expected influence values in the networks. The NCT results revealed that the edge weights significantly differed between patients with mild to moderate OSA and those with severe OSA (M = 0.263, p = 0.008). There was no significant difference in global strength variation between the two networks (S = 0.185, p = 0.773). Conclusions Our results suggest that the highest expected influence value and bridge symptoms (e.g., A6 and D6) can be prioritized as potential targets for intervention and treatment in patients with OSA.https://doi.org/10.1186/s12888-025-06532-wObstructive sleep apneaDepressiveAnxietySleep disturbanceNetwork analysis
spellingShingle Xue Luo
Shuangyan Li
Qianyun Wu
Yan Xu
Ruichen Fang
Yihong Cheng
Bin Zhang
Depressive, anxiety, and sleep disturbance symptoms in patients with obstructive sleep apnea: a network analysis perspective
BMC Psychiatry
Obstructive sleep apnea
Depressive
Anxiety
Sleep disturbance
Network analysis
title Depressive, anxiety, and sleep disturbance symptoms in patients with obstructive sleep apnea: a network analysis perspective
title_full Depressive, anxiety, and sleep disturbance symptoms in patients with obstructive sleep apnea: a network analysis perspective
title_fullStr Depressive, anxiety, and sleep disturbance symptoms in patients with obstructive sleep apnea: a network analysis perspective
title_full_unstemmed Depressive, anxiety, and sleep disturbance symptoms in patients with obstructive sleep apnea: a network analysis perspective
title_short Depressive, anxiety, and sleep disturbance symptoms in patients with obstructive sleep apnea: a network analysis perspective
title_sort depressive anxiety and sleep disturbance symptoms in patients with obstructive sleep apnea a network analysis perspective
topic Obstructive sleep apnea
Depressive
Anxiety
Sleep disturbance
Network analysis
url https://doi.org/10.1186/s12888-025-06532-w
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