An exploration of adult attachment insecurity and psychiatric symptoms in individuals with obstructive sleep apnea

• Published in: Journal of psychosomatic research Vol. 123; p. 109731
• Main Authors: Adams, G. Camelia, McWilliams, Lachlan A., Wrath, Andrew J., Mondal, Prosanta, Harder, Jane A., Skomro, Robert, Fenton, Mark E.
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.08.2019; Elsevier Science Ltd
• Subjects: Adult; Adult attachment; Adults; Anxiety; Anxiety - etiology; Anxiety - psychology; Apnea; Attachment; Avoidance behavior; Comorbidity; Cross-Sectional Studies; Day time; Daytime; Daytime sleepiness; Depression; Depression - etiology; Depression - psychology; Female; Health risk assessment; Humans; Insecurity; Interdisciplinary aspects; Longitudinal Studies; Male; Medical diagnosis; Mental depression; Middle Aged; Mood; Obstructive sleep apnea; Polysomnography; Psychiatric symptoms; Psychotic Disorders - etiology; Quality; Reactive Attachment Disorder - etiology; Severity; Sleep; Sleep and wakefulness; Sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - psychology; Sleep deprivation; Sleep disorders; Sleep quality; Sleepiness; Symptoms; Sleep quality; Depression; Anxiety; Daytime sleepiness; Obstructive sleep apnea; Adult attachment
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2019.05.009

Obstructive sleep apnea (OSA) is a common sleep disorder, often associated with multiple medical comorbidities as well as psychological difficulties. Among the latter, relationship difficulties as well as mood and anxiety symptoms have been reported, without a clear understanding of the mechanism. In the current study we wanted to further explore these aspects, while comparing groups of OSA individuals with good vs poor sleep. The primary goal of the study was to examine the relationship between sleep and adult attachment and secondly to explore the relationship between sleep and couple satisfaction as well as symptoms of depression and anxiety. Following diagnosis of OSA by overnight polysomnography, 102 participants completed several psychological measures (e.g. adult attachment, couple satisfaction, depression and anxiety symptoms) and sleep measures (sleep quality and daytime sleepiness). Variables of interest were compared between the OSA groups with either good/poor sleep quality or no/excessive daytime sleepiness. Adult attachment avoidance was higher in individuals with low sleep quality (mean difference = 0.33, p = .04, d = 0.46) while adult attachment anxiety was higher in individuals with high daytime sleepiness (mean difference = 0.46, p = .04, d = 0.43). Individuals with either poor sleep quality or excessive daytime sleepiness had greater severity of depression and anxiety (both p < .05). OSA patients with poor sleep quality and excessive daytime sleepiness have greater attachment insecurity and higher levels of depression and anxiety. A multidisciplinary approach including psychological interventions, should be considered in OSA cases with high levels of sleep disturbance. •Attachment avoidance is higher in OSA individuals with poor sleep quality.•Attachment anxiety is higher in OSA individuals with excessive daytime sleepiness.•Depression and anxiety are higher in OSA individuals with poor sleep quality.•Depression and anxiety are higher in OSA individuals with excessive daytime sleepiness.